CANCER AND PREGNANCY

Abstract

Cancer during pregnancy is not a common problem, but when it is detected, a serious clinical situation arises. The coexistence of a malignant neoplasm and pregnancy is a condition in which there is an ambiguous dilemma about the simultaneous development of a new life and a life-threatening disease. Ultimately, the doctor managing this patient faces two problems - the struggle for life as well the mother as the unborn child. Based on the literature studied from the MedLine database, an analytical review of cancer information during pregnancy in 2014-2018 was conducted. The pregnancy is established to be most often combined with the following oncological diseases: cervical and breast cancer (62% each), stomach and rectal cancer (11% each), ovarian cancer (5.5%). In addition, the literature describes isolated cases of lung cancer and brain tumors during pregnancy. During information processing, the late both first pregnancy, and first births it was revealed to increase the risk of cancer. Treatment of such patients should be carried out in specialized centers, and for all cases it is necessary to collect a consultation team consisting of oncologists, surgeons, obstetricians-gynecologists, radiologists, neonatologists and pediatricians. Over the past 20 years in world practice, the most preferred approach is a comprehensive start of treatment of patients without interrupting pregnancy, therefore the survival rate of both mother and fetus tends to increase.

Keywords

review / cancer during pregnancy / cervical cancer / breast cancer / ovarian cancer / treatment

References

[1] Davutoğlu A.E., Madazlı R., Yılmaz N., Ozel A., Uludag S., Sozen I. Pregnancy in cancer patients and survivors; experience of a university hospital in Turkey. J. Obstet. Gynaecol. 2017; 37(8): 1015-9. doi: 10.1080/01443615.2017.1318265

[2] Серов В.Н., Шмаков Р.Г., Полушкина Е.С., Волочаева М.В. Рак и беременность. Руc. мед. журн. 2015; 20: 1195-7.

[3] Skrzypczyk-Ostaszewicz A., Rubach M. Gynaecological cancers coexisting with pregnancy. Contemp. Oncol. (Pozn.). 2016; 20(3): 193-8. doi: 10.5114/wo.2016.61559

[4] Zagouri F., Dimitrakakis C., Marinopoulos S., et al. Cancer in pregnancy: disentangling treatment modalities. ESMO Open. 2016; 1: e000016. doi: 10.1136/esmoopen-2015-000016BMJ

[5] Sekine M., Kobayashi Y., Tabata T., Sudo T., Nishimura R., Matsuo K. et al. Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis. BMC Pregnancy Childbirth. 2018;18(1): 50. doi: 10.1186/s12884-018-1678-4

[6] Knabben L., Mueller M.D. Breast cancer and pregnancy. Horm. Mol. Biol. Clin. Investig. 2017; 32(1). doi: 10.1515/hmbci-2017-0026

[7] Amant F., Deckers S., Van Calsteren K. et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur. J. Cancer. 2010; 46: 3158-68. doi:10.1016/j.ejca.2010.09.010

[8] Funston G., O’Flynn H., Ryan N.A.J., Hamilton W., Crosbie E.J. Recognizing gynecological cancer in primary care: risk factors, red flags, and referrals. Adv. Ther. 2018; 35(4): 577-89. doi: 10.1007/s12325-018-0683-3

[9] Cordeiro C.N., Gemignani M.L. Gynecologic malignancies in pregnancy: balancing fetal risks with oncologic safety. Obstet. Gynecol. Surv. 2017; 72(3): 184-193. doi: 10.1097/OGX.0000000000000407

[10] Wang F.W., Fu S.M., Jin Y.C., Gong X.H., Cheng H.D., Wu K.J. Retrospective analysis of diagnosis and treatment of breast cancer in pregnancy. Zhonghua Wai Ke Za Zhi. 2018; 56(2): 114-8. doi: 10.3760/cma.j.issn.0529-5815.2018.02.007

[11] Baulies S., Cusidó M., Tresserra F., Rodríguez I., Ubeda B., Ara C., Fábregas R. Pregnancy-Associated Breast Cancer: an analytical observational study. Med. Clin. (Barc). 2014; 142(5): 200-4. doi: 10.1016/j.medcli.2012.12.020

[12] Sekine M., Kobayashi Y., Tabata T., Sudo T., Nishimura R., Matsuo K. Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis. BMC Pregnancy Childbirth. 2018; 18(1): 50. doi: 10.1186/s12884-018-1678-4

[13] Tesařová P. Pregnancy-associated breast cancer. Klin. Onkol. 2016; 29 Suppl 3: S16-22. doi: 10.14735/amko20163S16

[14] Basta P., Bak A., Roszkowski K. Cancer treatment in pregnant women. Contemp. Oncol. (Pozn). 2015; 19(5): 354-60. doi: 10.5114/wo.2014.46236

[15] Fruscio R., de Haan J., Van Calsteren K., Verheecke M., Mhallem M., Amant F. Ovarian cancer in pregnancy. Best Pract. Res. Clin. Obstet. Gynaecol. 2017; 41: 108-17. doi: 10.1016/j.bpobgyn.2016.09.013

[16] Husz V., Bus D., Vajda G. Extremely large epithelial ovarian cancer associated with pregnancy: a case report. Mol. Clin. Oncol. 2018; 8(1): 103-6. doi: 10.3892/mco.2017.1501

[17] Hecking Th., Abramian A., Domröse Ch., Engeln T., Thiesler Th., Leutner C. et al. Individual management of cervical cancer in pregnancy. Arch. Gynecol. Obstet. 2016; 293(5): 931-9.

[18] Xiang Zhang, Yong-liang Gao, Yue Yang. Treatment and prognosis of cervical cancer associated with pregnancy: analysis of 20 cases from a Chinese tumor institution. J. Zhejiang Univ. Sci. B. 2015; 16(5): 388-94. doi: 10.1631/jzus.B1400251

[19] Córdoba O., Llurba E., Saura C., Rubio I., Ferrer Q., Cortés J., Xercavins J. Multidisciplinary approach to breast cancer diagnosed during pregnancy: maternal and neonatal outcomes. Breast. 2013; 22(4): 515-9. doi: 10.1016/j.breast.2012.10.005

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