Multidisciplinary consensus on cancer management during pregnancy
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SPECIAL ARTICLE
Multidisciplinary consensus on cancer management during pregnancy A. Cubillo1 · S. Morales2 · E. Goñi3 · F. Matute4 · J. L. Muñoz5 · D. Pérez‑Díaz6 · J. de Santiago7 · Á. Rodríguez‑Lescure8,9 Received: 21 July 2020 / Accepted: 31 August 2020 © The Author(s) 2020
Abstract Cancer during pregnancy is a challenge for multi- and interdisciplinary collaboration due to the diagnostic, prognostic and therapeutic implications, the need for an integrated harmonization of medical action for the pregnant patient and the embryo or foetus and the characteristics of each gestational period, which will determine the protocol to be proposed and its limitations. For this reason, a group of experts appointed by participating scientific societies, which includes the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica—SEOM), the Spanish Association of Surgeons (Asociación Española de Cirujanos—AEC), the Spanish Society of Gynaecology and Obstetrics (Sociedad Española de Ginecología y Obstetricia—SEGO), the Spanish Society of Nuclear Medicine and Molecular Imaging (Sociedad Española de Medicina Nuclear e Imagen Molecular—SEMNIM), the Spanish Society of Oncological Radiotherapy (Sociedad Española de Oncología Radioterápica—SEOR) and the Spanish Society of Medical Radiology (Sociedad Española de Radiología Médica—SERAM), have worked together to establish consensus recommendations that allow the harmonization of management and ultimately the optimization of the healthcare of pregnant patients with cancer. When cancer is detected in a pregnant woman, the week of gestation in which the diagnosis is made must be considered, as well as the characteristics of the tumour. It is strongly recommended that a multidisciplinary team assesses the situation and guides the patient and her family during the informing, diagnosis and treatment process. Likewise, the foetus should be monitored and managed by specialized obstetricians who are part of a multidisciplinary cancer committee. Keywords Antineoplastic agents · Child development · Diagnosis · Follow-up · Prenatal care · Radiotherapy · Surgery · Systemic therapies
Introduction Gestational cancer is defined as cancer that occurs during pregnancy or during the year after delivery. In European countries, the incidence of gestational cancer has remained stable during the twenty-first century, after an annual increase of 1.5% in the final decades of the last century, with an incidence of 90-120 cases per 100,000 pregnancies [1, 2]. Among them, breast cancer ranks first by frequency, accounting for a third of all incident cases. After breast cancer, then thyroid cancer, cervical cancer, lymphomas and melanoma follow, ranked from high to low incidence (Table 1) [2, 3]. The delay in the age of pregnancy in the West carries an increased risk of gestational cancer, being * A. Cubillo [email protected] Extended author information available on the last page of the article
4 times higher in women over the age of 40 years compared to those under 30 years of age
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