Gastroesophageal Cancer During Pregnancy: a Case Report and Review of the Literature

Excerpt

Incidence of cancer during pregnancy is likely increased nowadays in developed societies and clinical practice due to women’s increasing trend toward late childbirth [1]. While cancer develops in approximately 1 to 2 per 1000 pregnant women, the diagnosis of esophageal or gastric cancer during pregnancy or the lactation period is very rare, accounting for only 0.026 to 0.1% of all pregnancies [2]. Gastroesophageal junction (GEJ) cancer diagnosis during pregnancy is usually delayed due to low index of suspicion for having a malignant disease at a young age. Symptoms such as abdominal pain, nausea, vomiting, and fatigue can be mistaken as part of physiologic gestational symptoms and anemia as a laboratory finding. Additionally, this group of patients has some distinct features that may affect disease course such as being of young age, female gender, mostly being diagnosed at advanced stage, having a passive attitude toward treatment due to concerns about fetal health, and increased treatment challenges during pregnancy [3]. Early diagnosis allows appropriate management with a multidisciplinary approach. Contemporary evidence suggest that chemotherapy can safely be given starting at 12 to 14 weeks of gestational age and radiotherapy of upper body parts, with adequate shielding, is expected to be safe during the first and second trimesters of pregnancy if the tumor is located sufficiently far from the fetus [4]. Low-risk surgery during pregnancy is feasible in all trimesters of pregnancy [5, 6]. …