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  • Title: [Pregnancy and oncological diseases].
    Author: Ivanov S.
    Journal: Akush Ginekol (Sofiia); 2012; 51(1):27-33. PubMed ID: 22639776.
    Abstract:
    AIM: The oncological diseases during pregnancy are very rare, but the incidence rate is constantly increasing. The diagnosis and treatment of the cancer during pregnancy are connected with the risk of the diagnostic procedures on the foetus and the risk of the treatment methods upon the developing foetus. That is why we decided to assess and research our and foreign experience in this field. MATERIAL AND METHODS: We performed a retrospective research work in this field. For 10 years period we examined: -20 patients with precancer and cancer of the vulva combined with pregnancy -70 patients with cervical cancer and pregnancy -30 patients with ovarian cancer and pregnancy -60 patients with breast cancer and pregnancy The most important point in the diagnosis and treatment of the oncological diseases connected with pregnancy is not to delay the treatment of the pregnant woman. RESULTS: The patients with early stages of the cervical cancer connected with pregnancy are treated conservatively. The patients with invasive cervical cancer and pregnancy-the gestational age and the wish of the patient to have a baby are the main factors formulating the kind of treatment. In early 1-st and II-nd trimester the patients with IB and IIA stage are treated with radical hysterectomy together with the foetus or the standard chemo-radiotherapy. Advanced cervical cancer-IB2-II stage. In these patients pelvic radiotherapy with chemotherapy is used if the cancer is diagnosed in the first 20 gestational weeks. Acording to us and the most foreign authors the adnexal masses must be eradicated surgically in the II-nd trimester of the pregnancy (13-16 gestational weeks). The most ovarian cancers are in early stage and chemotherapy may be delayed after the delivery especially for epithelial tumors I-st stage. DISCUSSION: In precancer and cancer of the uterine cervix as well as in all other oncogynaecological and oncological diseases combined with pregnancy we offer 2 algorithms to be used. CONCLUSION: The oncolgical types of treatment including surgery, chemotherapy and radiotherapy(with exception of radiotherapy for small pelvis and abdominal cavity) may safely be applied after the I-st trimester of the pregnancy.
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