Some pregnancies can continue despite cervical, ovarian cancers

Share this article:

The current trend is to preserve pregnancy in women diagnosed with cervical or ovarian cancer whenever feasible, according to a recent review that explored the issues around gynecologic cancers (Lancet. 2012;379:558-569).

Gynecologic cancers are the most common malignancies diagnosed during pregnancy (mainly uterine or cervical and, less frequently, ovarian), note the review authors. The use of chemotherapy during pregnancy helps increase the chances of fetal preservation, and most case reports describing chemotherapy for gynecologic cancers during pregnancy show a good outcome for the newborn. Congenital anomalies, preterm deliveries, and growth restrictions do not appear to be any more common in children exposed to chemotherapy in utero after the first trimester than in unexposed children. However, few studies have looked at the long-term development of babies exposed to chemotherapy as fetuses.

In early-stage cervical cancer involving a small tumor and no nodal spread, postponing treatment until after the baby is born might be possible. Delaying treatment until after childbirth in women with stage 1A disease has an excellent prognosis and is now the standard of care. Another option is to remove the cervix by means of radical trachelectomy to preserve the uterus and the pregnancy.

Management of locally advanced cervical disease is more controversial, centering on neoadjuvant chemotherapy with preservation of the pregnancy, or chemotherapy and radiotherapy with termination of the pregnancy. These choices should be discussed based on tumor size, radiologic findings, trimester of pregnancy, and the patient's wishes.

In ovarian disease, management depends on histologic subtype of the malignancy, tumor differentiation, nodal status, tumor stage, and trimester of pregnancy. Ovarian tumors of low malignant potential have an excellent prognosis and are treated surgically, without chemotherapy, in most patients. If the tumor is malignant, neoadjuvant chemotherapy with pregnancy preservation may be possible in a woman with peritoneal spread or high-risk, early-stage disease.

Epithelial ovarian cancer is the rarest ovarian cancer in pregnant women and has an overall low incidence. However, it is the most difficult form of ovarian cancer to treat and it has a worse overall prognosis than do nonepithelial tumors. In some early-stage cases, the pregnancy can be preserved. Other women may need to undergo a pregnancy-terminating hysterectomy.

Share this article:
You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

April Contest: Win a Pebble Watch

Start the contest today

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs

More in Web Exclusives

New gene implicated in progression and recurrence of triple-negative breast cancer

A gene not previously associated with breast cancer appears to play a pivotal role in the growth and progression of triple-negative breast cancer.

Germline EGFR T790M mutation indicates a high risk for familial NSCLC regardless ...

Two studies provide new insight into a germline epidermal growth factor receptor T790M mutation in familial non-small cell lung cancer, and suggest the need for tailored approaches for early detection and treatment.

Hope for preserving fertility in young boys with cancer

Scientists have moved a step closer to being able to preserve fertility in young boys who undergo chemotherapy and radiation treatments for cancer.