12 - Cervical and endometrial cancer in relation to pregnancy

Summary

Introduction

The diagnosis of cancer confronts patients, their families and carers with considerable challenges. The assessment of the disease, discussion of treatment options and the effects of treatment in both the short and long term need to be addressed. For women with gynaecological cancers, these challenges include the effect on perceptions of womanhood and, for some, the effect on future fertility.

This chapter considers cervical and endometrial cancer in relation to pregnancy, dealing with both the situation where the diagnosis is made at a time when future pregnancy is desired and the situation where the diagnosis is made during pregnancy. The issues surrounding diagnosis and treatment in these situations differ in some important respects.

For women diagnosed at a time when future fertility is desired, it is important to provide adequate information on the treatment options as well as the likely chances of subsequent pregnancy and the potential complications of treatment that may affect such pregnancies.

After the diagnosis of cancer, patients and their families are emotionally vulnerable. Treatment options must be considered along with the psychosocial consequences of those choices. There will be situations where a fertility-sparing treatment may be considered that, from a purely oncological point of view, may result in a poorer outcome but that the woman finds acceptable in view of the fertility-preserving nature of such a treatment. Full discussion of these issues is crucial to help women and their families plan the appropriate individualised management strategy in each case.