Management of cancer during pregnancy emphasizing maternal and fetal effects

One in 1000 pregnancies is complicated by maternal cancer. The most frequently encountered malignancies are breast cancer, hematologic tumors, and skin cancer. Cancer management implies multidisciplinary decisions taking into account the (sub)type and stage of cancer, the gestational age at diagnosis, and patient's wish to preserve the pregnancy. Oncological treatment modalities including surgery, radiotherapy, and chemotherapy are possible during pregnancy, however, under strict conditions. Actually, pregnant patients receive the same dosages of chemotherapeutic agents as nonpregnant women, despite gestational changes in hemodynamics and drug pharmacokinetics. Data on the outcome of the children are limited. Neonatal outcome seems reassuring, albeit data on long-term outcomes are lacking. Cancer during pregnancy poses a real challenge for obstetricians, oncologists, and pediatricians to balance fetal and maternal risks and benefices. Here, we address some important clinical issues related to the management of cancer complicating pregnancy.