What do we know about the psychosocial issues associated with cancer during pregnancy? A scoping review and gap analysis

Abstract

ObjectivesThere is a global increase in the number of women diagnosed with cancer during their pregnancy and a nascent evidence base to guide their supportive care. The purposes of this study were to (1) map research on the psychosocial issues affecting women and their partners on diagnosis and treatment for cancer during pregnancy; (2) determine available supportive care or educational interventions; and (3) identify knowledge gaps for future research and development.DesignScoping review.Search strategySix databases were searched (Scopus, CINAHL, PsycINFO, Medline, Intermid, Maternal and Infant Health) to retrieve primary research (January 1995 to November 2021) investigating women and/or their partner’s decision-making and their psychosocial outcomes during and after pregnancy.Data extraction and synthesisSociodemographic, gestational and disease characteristics of participants and psychosocial issues identified were extracted. Leventhal’s self-regulatory model of illness provided a framework for mapping study findings enabling evidence synthesis and gap analysis.ResultsTwelve studies were included, conducted in eight countries in six continents. Most women (70% of 217) were diagnosed with breast cancer during pregnancy. Reporting of sociodemographic, psychiatric, obstetric and oncological characteristics that are important in assessing psychosocial outcomes was inconsistent. None of the studies had a longitudinal design and no supportive care or educational interventions were identified. The gap analysis highlighted the lack of evidence about pathways to diagnosis, impact of late effects and how internal/social resources may affect outcomes.ConclusionsResearch has focused on women with gestational breast cancer. Little is known about those diagnosed with other cancers. We encourage future study designs to capture data on sociodemographic, obstetric, oncological and psychiatric characteristics and adopt a longitudinal approach to explore the longer term psychosocial impact on women and their families. Future research should include outcomes that are meaningful for women (and their partners) and draw on international collaboration to accelerate progress in this field.

CAnceR IN PreGnancy (CARING) – a retrospective study of cancer diagnosed during pregnancy in the United Kingdom

“…The ethnicity data is in keeping with UK census data and national audits of the characteristics of all women who gave birth [ 17 ], suggesting this dataset is broadly representative of the UK population. Compared with the INCIP group, fewer of the UK cohort were first-time mothers (44–56% and 34.2%, respectively), which is notable because previous research suggests parity can be important factor for patients where there are decisions around continuation with pregnancy and delaying treatment, and has implications for managing treatments alongside existing parenthood [ 18 ].…”

Gestational Renal Cell Cancer – An Update

“…Within a short period, the pregnant patient must make informed treatment decisions that have implications not only for their long-term health but also for the well-being of their unborn child. In this context, the members of the multidisciplinary team play a vital role in supporting the pregnant patient, ensuring the optimization of the decision-making process while upholding the fundamental ethical principle of patient autonomy (55).…”

Breast cancer in pregnancy: concurrent cesarean section, nipple-sparing mastectomy, and immediate breast reconstruction—case report

“…Due to the breast physiological changes occurring in pregnancy, PABC could pose a severe diagnostic challenge ( 3 , 4 ). Moreover, psychological and ethical aspects play a crucial role in PABC because the appropriate management must fulfill both the oncological threat and the pregnancy ( 5 – 7 ).…”