Cancer treatment in pregnant women

Abstract

In general, strategies for the treatment of cancer in pregnancy should not differ significantly from the treatment regimens in non-pregnant women. However, this is difficult due to either the effects of anticancer drugs on the developing foetus or the possibility of long-term complications after the exposure to drugs and radiation.The decision about the introduction and continuation of treatment in the event of pregnancy should be preceded by a detailed analysis of the potential benefits and risks. There are no data to suggest that pregnancy termination alters the biological behaviour of the tumour or patient prognosis in the presence of appropriate antineoplastic therapy. All patients should be given appropriate advice and informed that there are insufficient scientific data to determine any generally accepted consensus. It is very important to always respect the will of the patient, and the moral judgment of the physician should have no impact on the decisions taken by the woman. If the woman decides to undergo active treatment and maintain her pregnancy, it is necessary to carry out consultations with experts in the field appropriate to the type of cancer. This paper presents a basic review of the literature on the targeted therapies currently used in selected cancers diagnosed during pregnancy: breast cancer, cervical cancer, Hodgkin's disease, melanoma, thyroid cancer, ovarian cancer, and colorectal cancer.

Pregnancy, delivery, and breastfeeding after total gastrectomy for gastric cancer: a case report

“…In general, strategies for the treatment of cancer in pregnancy are not different from the treatment regimens in non-pregnant women [12]; however, a woman cancer survivor who wants children might concern about the effects of adjuvant chemotherapy on future fertility or on future offspring. Bedschi et al [13] reported that age of the patient and the type and dose of chemotherapy are the main factors determining the magnitude of the damage in the ovary.…”

“…As for gastric cancer, TS-1 (tegafur, gimeracil, oteracil potassium), which is used as the standard adjuvant chemotherapy for patient with gastric cancer in Japan [14], and CDDP (cisplatin) are classified intermediate and low gonadotoxic chemotherapy respectively. However, there are limited data on fertility after any type of chemotherapy, and these data are difficult to interpret strictly [12]. For these facts, oocytes or fertilized egg cryopreservation would be better for young women, who want to have children following treatment, before receiving adjuvant chemotherapy.…”

Gastric cancer in pregnancy: is laparoscopic gastrectomy with lymph node dissection feasible and safe?

“…There are no data to suggest that pregnancy termination alters the biological behavior of the tumor or patient prognosis in the presence of appropriate antineoplastic therapy [6]. …”

Problemy hematologiczne w okresie ciąży

“…Podstawą rozpoznania jest badanie histologiczne, a ciąża nie stanowi przeciwwskazania do wykonania biopsji zajętego narządu, w tym biopsji węzła chłonnego i trepanobiopsji szpiku. Wykonanie zabiegu w znieczuleniu miejscowym jest bezpieczne w każdym okresie ciąży, natomiast pobranie materiału do badania histopatologicznego w znieczuleniu ogólnym jest bezpieczne po upływie I trymestru [26][27][28].…”

“…Hemodylucja, zmniejszone stężenia albumin, zwiększony klirens nerkowy i wątrobowy zmieniają metabolizm leków, szybkość ich wydalania oraz biodostępność [26,27].…”