AppId is over the quota
A recent paper published in the The Lancet reviewed the management and treatment of gynaecological cancers during pregnancy - most common types being cervical and ovarian. The goal among such cases is to prolong and prevent termination of pregnancy, whilst also treating the cancer in the most effective way possible. The paper was by Professor Philippe Morice, Department of Gynecological Surgery, Institut Gustave Roussy, France, and colleagues.
The authors said:
"In early-stage cervical cancer during the first and at the beginning of the second trimester, the two main considerations for management of the patient are the tumour size (and stage) and nodal staging...In patients with a small tumour and without nodal spread, an intentional delay (with a careful clinical and radiological follow-up) to postpone treatment of the tumour until fetal maturity and delivery could be discussed."
Around 1 in 1000 pregnant women are diagnosed with cancer, this number is increasing in developed countries, though the age at which women are giving birth is increasing. European reccomendations state that if oncologically safe and feasible, pregnancy should be preserved.
The management of cervical cancer among pregnant women depends on four factors:the size and stage of the tumornodal statusterm of pregnancyhistological subtypeThe authors add:
"The management of patients with locally advanced cervical disease is controversial (neoadjuvant chemotherapy with preservation of the pregnancy or chemotherapy and radiotherapy) and should be discussed on a case-by-case basis according to the tumor size, radiological findings, the term of pregnancy, and the patient's wishes."
Selecting the type of treatment is very complex among pregnant women with gynaecological cancer, as more often than not the course of action that treats the cancer most effectively also risks termination of the pregnancy. This is especially true among patients with locally advanced cervical cancer (stage II or greater), where chemoradiation therapy is more effective at optimizing a local control compared to neoadjuvant (pre-surgery) chemotherapy, but chemoradiation adds higher risk of terminating the pregnancy. Choosing between treatment types is tough in these delicate situations and must be assessed on an individual basis.
The treatment and management of the different histological types of malignant ovarian diseases that develop during pregnancy depends on: the diagnosis, the term of the pregnancy, and the tumor stage. In some cases where patients have high-risk early-stage disease, neoadjuvant chemotherapy along with pregnancy preservation measures may be the best course of action.
Although chemotherapy is not a suitable form of treatment for women in their first 8 weeks of pregnancy, as it harms the fetus, there is evidence indicating that it is a suitable form of treatment for those in their second or third trimester.
The authors said:
"The use of chemotherapy during pregnancy helps increase the chances of fetal preservation. Children exposed to chemotherapy in utero after the first trimester do not seem to have more congenital anomalies."
They note that these types of pregnancies have an increased risk of premature birth and that thorough medical assessment is necessary throughout the pregnancy.
Prof Morice comments:
"Data about the effects on the fetus and newborn of exposure to chemotherapy are scarce. Large series are awaited, particularly to evaluate long-terms effect of these treatments."
Written by Joseph Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Additional References Citations Visit our pregnancy / obstetrics section for the latest news on this subject. Cancer in pregnancy: a challenging conflict of interest
Philippe Morice, Catherine Uzan and Serge Uzan
The Lancet, Feb 2012. doi:10.1016/S0140-6736(11)61814-X Please use one of the following formats to cite this article in your essay, paper or report:
MLA
Joseph Nordqvist. "The Complexities Of Treating Gynaecological Cancers During Pregnancy." Medical News Today. MediLexicon, Intl., 13 Feb. 2012. Web.
16 Feb. 2012.
Joseph Nordqvist. (2012, February 13). "The Complexities Of Treating Gynaecological Cancers During Pregnancy." Medical News Today. Retrieved from
http://www.medicalnewstoday.com/articles/241591.php.
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