Pregnancy should delay the treatment of malignant disease not. The therapy is similar to the treatment of non pregnant women, except for rectal and gynecological tumors.
(Gynecological tumors.) Pregnancy should delay the treatment of malignant disease not. The therapy is similar to the treatment of non pregnant women, except for rectal and gynecological tumors. Because embryonic tissues grow rapidly at a high rate of DNA replication, they resemble malignant tissues and therefore are very vulnerable to antineoplastic agents. Many antimetabolite and alkylating agents (eg. As busulfan, chlorambucil, cyclophosphamide, 6-mercaptopurine, methotrexate) may cause fetal abnormalities. Especially methotrexate is problematic; its use during the first trimester increases the risk for a spontaneous abortion and ongoing pregnancy for multiple congenital malformations. Although pregnancy can be ended successfully despite the treatment of malignant disease often, the risk of treatment-related damage to fetus causes some women to opt for an abortion. A rectal cancer rectal cancer requires in some cases, to ensure complete tumor removal, a hysterectomy. Caesarean sections can be performed as early as possible after the 28th week of pregnancy, followed by a hysterectomy, so an aggressive cancer treatment can be started. Cervical Pregnancy does not seem to worsen the disease of cervical cancer. Cervical cancer can develop during pregnancy, and a pathological Papanicolaou (Pap) smears should not be attributed to pregnancy. Pathological Pap smears followed by a colposcopy and biopsy if indicated targeted. A colposcopy does not increase the risk of an adverse pregnancy outcome. Before a cervical biopsy is recommended to have the colposcopy evaluated by a specialist and to coordinate with a pathologist because the biopsy can cause bleeding and preterm labor. If the investigation shows evidence of low grade lesions, no biopsy need not be carried out, especially when the cervical cytology suggests low gradige lesions. In carcinoma in situ (Federation of Gynecology and Obstetrics [FIGO] stage 0; see Table: Clinical staging of cervical cancer) and mikroinvasivem carcinoma (stage IA1), the therapy often postponed until after birth, since a conservative approach might be possible. In invasive cancer (FIGO stage IA2 or later) that pregnancy in consultation with a gynecologic oncologist should be supervised. If invasive cancer diagnosed in early pregnancy, an immediate, corresponding to the tumor therapy is usually recommended. If invasive cancer after 20 weeks is detected and the pregnant woman can accept a quantitatively uncertain risk increase, the treatment to the 3rd trimester (z. B. 32 weeks) will be moved to optimize fetal maturity, but without too long a delay of therapy. In patients with invasive carcinoma, a caesarean section is performed with radical hysterectomy; a vaginal delivery is avoided. Gynecological cancers after the 12th week of pregnancy, when the ovaries rise along with the uterus out of the basin and are no longer easy to scan, ovarian cancer is often overlooked. In far advanced disease ovarian cancer can lead to death during pregnancy, before this is finished. The affected women need as soon as possible a bilateral oophorectomy. Cancers of the endometrium and tubes rarely occur during pregnancy. Leukemia and Hodgkin’s lymphoma, leukemia and Hodgkin’s lymphoma are rare in pregnancy. The commonly used anticancer drugs increase the risk of miscarriage and congenital malformations. Since leukemia can be fatal very quickly, the therapy takes place as soon as possible without any significant delay, to mature the fetus. When a Hodgkin’s lymphoma is limited to the area above the diaphragm, a radiation therapy can be carried out; the abdomen must be covered. Is the lymphoma localized below the diaphragm, a termination of pregnancy would be advisable. The breast swelling of the breast during pregnancy detection of breast cancer can be very difficult. Each solid or cystic tumor in the breast should be ascertained (lesions of the breast (breast lumps): Clarification).