Cancers presenting in the head and neck during pregnancy

Abstract

It is recognized that with the dramatic rise in births among "reproductively" older women and with the changing epidemiology of squamous cell carcinoma of the head and neck in nonsmoking and nonalcohol-drinking women, there is to be expected an increased incidence and presentation. Management of such patients must consider the gestational age of the pregnancy and must include alternatives to current treatments to accommodate the individual's wishes regarding her pregnancy.

Avaliação epidemiológica de pacientes com câncer de cabeça e pescoço em um hospital universitário do noroeste do estado de São Paulo

“…18 In recent years there has been a significant increase in the incidence of head and neck tumors in females, probably due to changes in smoking and alcohol drinking habits. 12 There were more rural workers among males, and more housewives among females. A survey undertaken at the Head & Neck Surgery Unit of the Heliopolis Hospital in the state of Sao Paulo revealed that the most frequent occupation among males was that of bricklayer, with rural activities in sixth place; the most frequent occupation for females was that of housewife, followed by rural activities.…”

“…11 Although this form of cancer affects mostly males, there has been a significant increase in the incidence in females, probably reflecting changes in smoking and drinking habits. 12 The aim of this paper was to describe the social and demographic profile of head and neck cancer patients at a university hospital, and to identify the risk factors (smoking and alcohol drinking) to support disease prevention programs.…”

Radiotherapy and Pregnancy: Together or Alone?

“…41,42 These epidemiological changes and the tendency for women to delay pregnancy until their late reproductive years, increases the likelihood of head and neck cancers presenting during pregnancy. 43,44 Several groups of researchers have estimated fetal dose in the RT of brain tumors during pregnancy. 30,36,[45][46][47][48][49] The fetal-dose estimate for RT of grade 3 astrocytoma without shielding was 0.022 Gy for a tumor dose of 54 Gy for a 6 MV Varian accelerator and 0.49-0.59 Gy for an Asea Brown Boveri accelerator at 8 MV and 16 MV 45 .…”

Thyroid and parathyroid surgery in pregnancy

“…The maintenance of normal adequate O 2 and CO 2 levels is crucial to maintaining normal fetal physiology. A high concentration of at least 50% O 2 should be administered during the operation and arterial pCO 2 should be maintained at normal pregnancy levels (30)(31)(32)(33)(34)(35).…”

“…A study of the California Cancer Registry linked to maternal/neonatal hospital discharge identiWed a thyroid cancer incidence of 14.4 per 100,000 [29]. Finally, with the increasing age at which women are becoming pregnant, the incidence of cancer during pregnancy is likely to rise [30].…”