Cancer in pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20183288Keywords:
Cancer, Chemotherapy, Pregnancy, Radiotherapy, SurgeryAbstract
Cancer in pregnancy though rare is a challenging problem both for patient and obstetrician. It is on rise though pregnancy does not predispose cancer. Persistent symptoms like vomiting, abdominal pain, discharge etc should be thoroughly evaluated by clinical USG and if necessary by MRI if there is a strong suspicion of malignancy to detect early and treat promptly. A multidisciplinary discussion is necessary. Management depends on type of malignancy, stage, risk factors, histopathology and gestational age. Carcinoma of breast and cervix are common malignancies that occur in pregnancy. It is preferable to postpone surgery and CT till first trimester is completed. A through counseling is essential regarding termination of pregnancy, type of treatment and its effects in mother and fetus and prognosis. Aim should be curative treatment to the mother with some modifications in the treatment keeping in mind maternal and fetal safety.
References
Lishner M. Cancer in pregnancy. Ann Oncol. 2007;14(supplement 3):1-6.
Stovall M, Blackwell CR, Cundiff J, Novack DH, Palta JR, Wagner LK, et al. Fetal dose from radiotherapy with photon beams: report of AAPM Radiation Therapy Committee Task Group No. 36. Med Physics. 1995;22(1):63-82.
Van Calsteren K, Vergote I, Amant F. Cervical neoplasia during pregnancy: diagnosis, management and prognosis. Best Practice Res Clin Obstet Gynaecol. 2005;19(4):611-30.
Evans SR, Sarani B, Bhanot P et al. Surgery in pregnancy. Curr Probl Surg. 2012;49:333-8.
Cohen-Kerem R, Railton C, Oren D, Lishner M, Koren G. Pregnancy outcome following non-obstetric surgical intervention. Am J Surgery. 2005;190(3):467-73.
Yumi H. Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy. Surg Endosc. 2008;22(4):849-61.
Pearl J, Price R, Richardson W, Fanelli R. Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy. Surg Endosc. 2011;25(11):3479.
Amant F, Halaska MJ, Fumagalli M, Steffensen KD, Lok C, Van Calsteren K, et al. Gynecologic cancers in pregnancy: guidelines of a second international consensus meeting. Int J Gynecol Cancer. 2014;24(3):394-403.
Bednarz B, Xu XG. A feasibility study to calculate unshielded fetal doses to pregnant patients in 6‐MV photon treatments using Monte Carlo methods and anatomically realistic phantoms. Med Physics. 2008;35(7 Part1):3054-61.
Doll DC, Ringenberg QS, Yarbro JW. Antineoplastic agents and pregnancy. In Seminars Oncol. 1989;16(5):337-46.
Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol. 2004;5(5):283-91.
Vancalastern K, Heyns L, Smet FD, Eycken V, Gziri MM, Halaska M, et al. Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and neonatal outcome. J Clin Oncol. 2010;28:683-9.
Powell HR, Ekert H. Methotrexate-induced congenital malformations. Med J Australia. 1971;2(21):1076.
Pereg D, Koren G, Lishner M. Cancer in pregnancy: gaps, challenges and solutions. Cancer Treatment Rev. 2008;34(4):302-12.
Koren G, Carry N, Gagon R, Maxwell C, Nulman I, Senikas V. Cancer chemotherapy and pregnancy. Send to J Obstet Gynaecol Can. 2013;35(3):263-278
Alexander A, Samlowski WF, Grossman D, Bruggers CS, Harris RM, Zone JJ, Noyes RD, et al. Metastatic melanoma in pregnancy: risk of placental metastases in the infant. J Clin Oncol. 2003;21(11):2179-86
Avilés A, Neri N. Hematological malignancies and pregnancy: a final report of 84 children who received chemotherapy in utero. Clinical Lymphoma. 2001;2(3):173-7.
Aviles A, Neri N, Nambo MJ. Long-term evaluation of cardiac function in children who received anthracyclines during pregnancy. Ann Oncol. 2005;17(2):286-8.
