Cancer during Pregnancy
Which are the symptoms?
The spectrum of symptoms of cancer in pregnancy is very broad; most symptoms can be mistakenly attributed to the pregnancy condition (e.g. asthenia, nausea and vomiting, dysphagia, abdominal pain). Hence the difficulty of listing a specific list of signs and symptoms. The tumours most commonly associated with pregnancy are those that most frequently affect the fertile age: haematological tumours (leukaemia, lymphoma), breast cancer, melanoma, thyroid cancer).
How is it diagnosed?
Diagnosis is based in the first instance on history and a thorough general and obstetrical physical examination. Imaging modalities commonly used in clinical practice in the evaluation of neoplasia include ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and nuclear medicine studies. It is essential to always consider the compatibility of the required instrumental investigations with the state of pregnancy, which is why a multidisciplinary approach is necessary. In view of the wide variety of possible clinical pictures it is limiting to list a common diagnostic pathway for all patients.
How is it treated?
The type of treatment approach is decided in a multidisciplinary meeting. During pregnancy, chemotherapy, radiotherapy and surgical treatment are available. Further treatments will be considered on a case-by-case basis. At the IRCCS San Raffaele Hospital there is a specific outpatient clinic where pregnant women diagnosed with neoplasms are assessed collectively by an oncologist, gynaecologist, obstetrician, neonatologist, psychologist and other professionals on the basis of the clinical picture. From an obstetrical point of view, close monitoring of foetal growth and careful assessment of risk factors for preterm delivery are recommended.