Cancer and Pregnancy: A Practical Approach for the Gynecologist

Cancer during pregnancy is a rare event, occurring approximately once per 1,000 pregnancies annually, corresponding to 0.07% to 0.1% of all malignant tumours. The incidence of cancer in pregnancy is increasing maybe due to trends in delayed childbearing. The most common malignancies associated with pregnancy are, in order of decreasing frequency, melanoma and breast cancer, cervical cancer, lymphomas and leukaemias. Melanoma, hematopoietic malignancies and lung cancer are the only cancers that have been reported to metastasize to the placenta and foetus, while melanoma accounts for almost one third of all cases. Imaging during pregnancy should consider risks to the foetus. Treatment of cancer can often be safely administered with good maternal and foetal outcomes. Chemotherapy, radiotherapy, and surgery must be adapted to the pregnancy state. Psychological support is needed at all levels of care. In addition, the diagnosis of cancer during reproductive age is increased, so procedures for counselling women with newly diagnosed cancer for fertility preservation are necessary. Due to high survival rates and high quality of life after cancer, women should be given the opportunity to plan motherhood after cancer actively. This work will provide an updated review of the diagnosis, staging and treatment options for cancer during pregnancy and the tools for a complete oncofertility counselling.