Cancer Diagnosis During Pregnancy: Evaluating the Challenges Faced by Oncologists

Cancer during pregnancy is occurring more often than in the past, and it is estimated that cancer is diagnosed in approximately 1/1000 pregnancies. A consensus exists that management of these patients should prioritize survival of the mother and minimize teratogenic effects to the fetus, and utilize a multidisciplinary approach, involving medical oncology, surgical oncology, radiation oncology, radiology, and a maternal fetal medicine specialist. In spite of this consensus, there is not a standardized approach for treating cancer in women diagnosed during pregnancy. Due to the relative infrequency of this situation in the oncologic setting, the aims of this study were to determine how comfortable oncologists are discussing pregnancy issues related to treatment, specifically termination and fetal risks, to determine what oncologists view as their primary responsibilities in the management of a woman diagnosed with cancer during pregnancy, and to identify the challenges oncologists face when treating a woman diagnosed with cancer during pregnancy. An 18 question survey was developed and distributed to oncologists at The Methodist Hospital and the Memorial Hermann Hospital system. The results from 53 completed anonymous surveys showed that oncologists who have treated at least one patient diagnosed with cancer during pregnancy are significantly more likely to be comfortable treating this patient population (