Is it possible to have a child after blood cancer? Late labor and late pregnancy

August 25th, 2014 , 08:00 pm

Late childbirth: there is a time for everything?

My friend died. At the age of 35, six months after the birth of her child, she was diagnosed with cancer.

The same story as Zhanna Friske, and Khabensky’s wife, and other less noticeable women who decided to have a late birth. These cases are few, but they do exist, and they are enough to take into account the risk of cancer caused by childbirth after the age of 30.

In my environment, the second woman is already dying from cancer, provoked by severe postpartum hormonal imbalance. The first one was 37 years old. Another friend of mine, like Friske, was pulled out, but it cost a lot of money - the kind that less than one percent of the population has. Her husband is rich.

The older a woman is, the stronger and more irreversibly postpartum hormonal shocks can hit her. I don’t have statistics, but for myself I can say for sure: if there is even one chance in a million - and, as we all understand, it is higher - of getting cancer after childbirth, I pass. Everything has its time. Didn’t give birth within the time allotted by nature for childbearing? There is no point in tempting fate.

I thought that my position was shared by all sane women, until a friend who gave birth after 30 said: “I had serious problems with hormones before and during pregnancy, and this whole story could have ended with cancer. But I gave birth anyway.”

What makes women, knowing that the risk, albeit small, is there, give birth at the age of well over 20? Maternal instinct - ruthless and merciless? The same “maybe it will blow by”?

I asked this question to my “hormonally problematic” friend. The answer was:

My husband and I really wanted a child.
- What if it was cancer? Were you ready to receive it by giving life?
- No.

Bingo! Anya did not want to get seriously ill or sacrifice her life for the sake of her unborn child. She just hoped it wouldn't affect her. And it didn’t touch.

If it suddenly touched her, Anka would definitely be horrified, and she wouldn’t need any child. All she would need is to live on her own.

“Take it all back! Just give me back my life!” - that’s what it’s called, if you put aside the beautiful words about heroic motherhood, which are easy to throw around when a terrible disease does not affect you personally.

I want to ask the men. Knowing that late labor can cause cancer, would you allow your wife to give birth? Would you insist on having a child? Would you be willing to risk your wife's life for the sake of continuing your family line, or would you prefer not to continue it - just so as not to expose your beloved to the slightest blow? Be honest.

Girls, are you ready to give birth after 30, knowing that you risk getting cancer?

This information was recently reported by scientists from the United States.

Many experts once spoke about the fact that late motherhood can subsequently result in a number of negative consequences. However, there is a certain positive in the desire to become a mother in middle age.

American scientists undertook to prove the last statement and initiated a special study. About 5 thousand residents of Denmark and the United States took part in it. The study found that those women who gave birth to their children naturally were twice as likely to live a longer life.

Today, scientists do not undertake to analyze this pattern and name the reasons for the supposed longevity. In their opinion, those women who managed to conceive a child in adulthood have better health compared to their peers who do not succeed. In addition, some scientists are inclined to consider the hypothesis correct, according to which women who gave birth late inherited the longevity gene from their mothers.

Earlier, experts from the University of Southern California already reported that, in their opinion, having a baby after 30 years old helps a woman protect herself from cancer. Scientists reported that by delaying childbirth, women could reduce their risk of developing estrogen-dependent cancers, as well as protect themselves from rarer and more aggressive hormone-independent cancers. According to experts, those women who conceive easily in their middle years have a relatively healthier endometrium. Also, one should not discount the effect of estrogen on the body, which is very actively produced during pregnancy.

However, many scientists also have a completely different view on the birth of a child at a relatively mature age. According to British scientists, many modern women simply do not realize the risks that occur during pregnancy and childbirth after 35 years of age. During the study, it turned out that less than half of the women who were interviewed knew about the age-related increase in the risk of developing diabetes during pregnancy, as well as the increase in the frequency of cesarean sections. Therefore, experts recommend that women take more interest in the peculiarities of pregnancy and childbirth in adulthood.

Education: Graduated from Rivne State Basic Medical College with a degree in Pharmacy. Graduated from Vinnitsa State Medical University named after. M.I. Pirogov and internship at his base.

Work experience: From 2003 to 2013 – worked as a pharmacist and manager of a pharmacy kiosk. She was awarded diplomas and decorations for many years of conscientious work. Articles on medical topics were published in local publications (newspapers) and on various Internet portals.

Anna: This is the best drug. Now without him I will have to be sick for a long time.

Mikhail: Help me buy an Eberminu

Varvara: After I broke my leg and lost my former activity, I began to suffer from constipation, as it were.

Eldar: Well, take a course of Alflutop again, even though I don’t walk with a limp now, I had a knee when I was young.

All materials presented on the site are for reference and informational purposes only and cannot be considered a treatment method prescribed by a doctor or sufficient advice.

Cancer after childbirth

Cancer in women can be diagnosed during pregnancy or immediately after childbirth. Such a complex situation as cancer after childbirth requires special tactics for patient management on the part of gynecologists, obstetricians and oncologists.

Cancer after childbirth - causes

The formation of a malignant neoplasm in the postpartum period is associated with changes in the hormonal electrolytic and hemodynamic status of the body.

Cancer after childbirth can also develop as a result of the degeneration of an existing benign tumor into a malignant form. The occurrence of such clinical cases is explained by the acceleration of cellular growth processes during pregnancy.

Cancer after childbirth - causes and risk factors:

1. Predisposition along a genetic line. The presence of malignant neoplasms in direct relatives increases the chances of developing cancer several times.
2. Patients with chronic diseases of the female genital organs and general precancerous conditions are at increased risk of postpartum oncology.
3. Tobacco smoking and alcohol abuse in some cases can stimulate the formation of genetic mutations, which is the beginning of the process of tumor formation.

Symptoms and diagnosis of postpartum tumors

• Brain cancer after childbirth

Brain cancer after childbirth is characterized by patient complaints of frequent paroxysmal headaches, visual and hearing impairment. Also, patients note disorders of the psycho-emotional state, which manifests itself in the form of irritability, nervousness and disturbances in internal balance.

Diagnosis of brain tumors is carried out by a neurologist based on an external examination and tomography data. Layer-by-layer X-ray images processed using digital technologies allow the doctor to assess the size, location and spread of a malignant neoplasm.

The severity of the disease lies in the long painless period of development, which can last for ten years. Throughout this period, the tumor is defined as an erosive lesion of the cervix. A gynecologist may suspect initial uterine cancer based on the results of smears and papillomavirus analysis, which indicates infection of the body with type 16 or 17 papillomavirus.

A final diagnosis is possible only after a biopsy, which is a method of histological and cytological analysis of biological material removed from the affected area. Laboratory testing indicates the type and stage of cancer with maximum accuracy.

The disease in the early stages is characterized by the following manifestations:

1. Irregularities of the menstrual cycle.
2. An increase in tumor size is usually accompanied by pressure on the bladder and, as a result, patients experience a frequent urge to urinate.
3. Frequent pain attacks in the abdominal area, the intensity of which gradually increases.
4. General symptoms include low-grade fever, headaches, general weakness and loss of appetite.

In the later stages of the disease, the clinical picture manifests itself with pronounced signs of oncology.

Diagnosis of the disease is carried out by a gynecologist, who, if suspicion arises, refers the patient to a consultation with an oncologist. In specialized institutions, patients are offered to undergo X-ray tomography and biopsy. These techniques make it possible to study the structure and outline of pathological foci.

Cancer after childbirth - treatment

To select the correct treatment method, it is necessary to answer the question “Why does cancer occur after childbirth?” Determining the exact location of the tumor is the most important preparatory step for treatment.

The most common surgical method is used for oncology of the female reproductive system. Surgery in the early stages of tumors of the uterus and its appendages provides 80% postoperative survival. In cases of malignant lesions of brain tissue, it is not always possible to apply the surgical method, even in the early stages of the disease. This is due to the high probability of tumor localization near the vital centers of the brain.

The second most frequently used therapy in the postpartum period is tumor radiation therapy, which involves exposure to radiological radiation to destroy cancer cells. Radiation therapy can be used as an independent technique and as an addition to combination therapy for oncology.

Chemotherapy is considered a fairly effective tool in the fight against recurrent cancer. The course of taking cytostatic pharmaceuticals for each patient is developed individually.

Possible complications of cancer treatment after childbirth

• Relapse of the disease. Restoration of cancerous growth in the same place is often observed due to incomplete excision of the tumor.
• Damage to neighboring tissues and blood vessels, which in the case of a cerebral tumor can be fatal.
• Cancer intoxication of the body. The manifestation of the disease may be accompanied by an increase in dehydration of the body.

It is important to know:

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The information on the site is presented for informational purposes only! It is not recommended to use the described methods and recipes for treating cancer diseases on your own and without consulting a doctor!

Cervical cancer after childbirth

Cervical erosion is a defect (wound) in the vaginal part of the cervix. During an examination by a gynecologist, erosion appears as a bright red spot around the pharynx of the cervix. There is also a phenomenon called pseudoeorsia - when the epithelium of the internal canal of the cervix extends beyond its limits. Upon examination, pseudo-erosion looks like a red velvety area around the pharynx.

Cervical erosion after childbirth is often the cause of rupture during childbirth. The cervix seems to be turned inside out. Improper suturing of tears threatens the appearance of defects that bring discomfort to the woman. In this case, additional treatment is necessary, which can only be carried out a certain time after birth.

Diagnosis of cervical erosion after childbirth

To clarify the diagnosis, the doctor, in addition to examining the cervix after childbirth, must resort to some additional tests. For example, a smear is performed from the mucous membrane of the vagina itself and the vaginal part of the cervix. This method helps in identifying the degree of purity of the vagina, of which there are 4. Of these, the 3rd and 4th degrees indicate the presence of inflammation of the cervix after childbirth and the risk of erosion.

Tests are also taken to identify diseases that are sexually transmitted. Among them are chlamydia, trichomoniasis, gonorrhea, etc. They are often the cause of cervical erosion.

A cultural research method is also used - sowing microflora taken from the vagina in special nutrient media. The growth of a particular culture is assessed, on the basis of which appropriate conclusions are drawn.

Treatment of cervical erosion after childbirth

The goal of treatment is to remove the abnormal tissue. The choice of treatment method depends on the cause, stage of the disease, as well as the size and structure of the affected area.

Today, there are several modern and low-traumatic methods for treating cervical erosion. This is cryotherapy (freezing with liquid nitrogen), radio wave knife, laser therapy.

In particularly difficult situations, when ruptures and improper fusion of tissues occur in the postpartum period, repeated surgical intervention is used. Sometimes after childbirth, erosion appears as a result of hormonal imbalance. In this case, in addition to gynecological treatment procedures, the woman is prescribed hormonal therapy to correct hormonal levels. If erosion is caused by inflammatory processes in the uterus, additional antibacterial therapy is carried out.

Complications of cervical erosion

Erosion as such does not pose a threat to a woman’s health. However, in the absence of treatment, active proliferation of pathogenic bacteria - candida, chlamydia, trichomanas, etc. - occurs in its environment. They easily penetrate the uterus, appendages and ovaries. The result is a woman’s infertility.

The most dangerous complication of erosion is cervical cancer. This occurs as a result of the transformation of benign cells into malignant ones. Only breast cancer is more common in women than cervical cancer. In most cases, cervical cancer after childbirth overtakes a woman if she neglected treatment or did not complete the erosion.

To avoid these complications, you need to regularly visit a gynecologist, take all the necessary tests, and if pathologies are detected, treat them in a timely manner. But even if you are caught by cervical cancer, you should not fall into despair - in the initial stages, the disease is curable. The main thing is to believe in success and remember that in this world there is at least one living being that depends on you: your beloved baby, for whom you need to fight.

Uterine cancer after childbirth

Uterine cancer is considered the most common cancer of the female reproductive system. Since the disease is mainly diagnosed in late stages, the prognosis of the disease is negative. Malignant neoplasm of the uterus affects older women. The definitive cause of the formation of genetic mutations has not been established to date. One of the provoking factors for the diagnosis of uterine cancer after childbirth is considered to be changes in hormonal levels in the postpartum period.

Uterine cancer after childbirth - causes

Scientists indicate that the direct cause of uterine cancer is papilloma viruses types 16 and 18. Viral infection of the body occurs exclusively through sexual contact, after which the papilloma virus enters the body through the mucous membrane, but it is not identified in the circulatory system.

But a malignant neoplasm occurs after the addition of several more risk factors. These are additional provoking reasons why cancer develops after childbirth. There may be changes in the balance of hormones after the birth of a child or during menopause.

Uterine cancer after childbirth - symptoms

A distinctive feature of the disease is a long asymptomatic period, which is very difficult to diagnose due to the similarity of the destructive processes with ordinary erosive lesions of the cervix. At this stage, cervical cancer after childbirth is mainly diagnosed accidentally during an extended gynecological examination.

In the later stages of the disease, the patient exhibits clearly defined signs of uterine oncology, which include:

• Periodic vaginal discharge mixed with blood.
• Intense attacks of pain in the lower abdomen or back.

Diagnosis of uterine cancer after childbirth

Diagnosis of uterine cancer after childbirth is carried out by a gynecologist in the following order:

1. Traditional examination of the mucous membrane of the cervix using mirrors.
2. Removal of a scraping smear for subsequent cytological examination in the laboratory. In modern gynecological clinics, such a PAP test is carried out using special brushes that allow a sufficient number of epithelial cells to be included in the biological material. The presence of abnormal cells in the results may indicate the presence of an oncological process.
3. Colposcopy is a thorough examination of the surface of the vagina and uterus using a special optical device. There is also an extended method for this study, in which the mucous membrane is pre-treated with 3% acetic acid, which provokes the development of edema of the pathologically altered epithelium.
4. Biopsy. The technique of removing a limited area of ​​cancer tissue is carried out to establish a final diagnosis of the disease, indicating the stage and shape of the tumor.

Treatment of malignant neoplasms of the uterus in the postpartum period

Uterine cancer after childbirth is treated in three main ways:

The most common type of surgery is hysterectomy, that is, excision of the uterine body. Also, if the pathological process has spread significantly, the surgeon may decide to completely resect the organ along with the appendages and nearby healthy tissues.

Radiation therapy for tumors is used at all stages of the disease and involves the use of highly active radiation to destroy cancer cells. The radiological method can be used in the form of:

• External influence, when the source of ionizing radiation is a special device that focuses X-rays on the affected area of ​​the body.
• Brachytherapy or internal therapy. The technique involves placing a radioactive substance into the vagina. After the procedure, this object is confiscated.

Radiation therapy in the vast majority of clinical cases is carried out as preoperative preparation for the patient in order to reduce the size of the tumor and stabilize oncological tissue growth. Another indication for radiological treatment is the late stage of cancer with a large number of metastases. In such cases, treatment procedures are aimed at reducing pain symptoms.

Cervical cancer after childbirth, which is subject to surgical treatment, can at the same time be treated with medication using cytostatic drugs that will destroy the walls of cancerous tumors. Such therapy is calculated strictly individually and is carried out in the form of cycles of intravenous injections.

Some types of malignant tumors of the uterus require additional use of hormonal drugs, since the surface of the tumor may contain receptors that are sensitive to the action of sex hormones. Such therapy can be carried out only in the initial stages of oncology, especially in women who wish to become pregnant again in the future. Side effects of hormonal therapy with progesterone can be considered a significant increase in weight, sensitivity of the mammary gland and systemic edema of the body.

It is important to know:

Uterine (endometrial) cancer detailed explanation

Causes of uterine cancer

Diagnosis of uterine cancer can be simple and timely if a woman regularly visits a gynecologist. After 40 years, it is better to do this every six months, since the risk at this age increases significantly. In addition to examination and palpation, the gynecologist makes a histological test, which can show the presence of “bad” cells. If you do not do this, then you can bring the process to an advanced state, because the disease can develop asymptomatically for quite a long time, and symptoms of uterine cancer, such as pain, can appear only in the last stages.

As a rule, the development of uterine cancer is preceded by various diseases:

I need a chair. There is no other way to understand it. When was the last time you visited a gynecologist?

Yes, it was in the summer, we had mandatory medical examinations at work. They told me that I had leukoplakia and sent me to such and such a clinic. Only I didn’t go. What am I, a fool? They get kickbacks from there.

Why didn’t you go somewhere else?

While talking we got closer to the inspection. Everything is bad. The cervix is ​​destroyed, the tumor has grown into the uterus and parametrial areas. At least stage 3-B. Up to the 4th stage, only distant metastases, lesions of the bladder and rectum are missing. However, this still needs to be verified.

At the Hertzin Institute they said there was cancer and gave me the phone number of a doctor (candidate of medical sciences, researcher at the department of gynecological oncology). The doctor ordered an MRI of the pelvic organs and an ultrasound. I also attach the results of both studies and an MRI video.

Having received the results, the doctor said that the only possible treatment was to remove the uterus and ovaries. Maybe they'll keep the right one, maybe they won't. Perhaps they will take one egg. The operation will probably be performed laparoscopically. He said that the consultation would clarify everything. He announced the approximate amount of the transaction.

How to detect cancer in the early stages?

Most endometrial tumors are detected in postmenopausal women. Therefore, the first symptom of uterine cancer is bleeding, which alarms most older women. In such cases, urgent consultation with a doctor and appropriate examination are necessary.

In young women, spotting is not so rare that a serious illness can be suspected. Therefore, it is very important to know the length of your menstrual cycle, the amount and duration of bleeding. If there are changes in the usual menstruation schedule, it is better to undergo an examination to exclude all serious causes.

Forms of endometrial cancer (according to histology results)

• Adenocarcinoma (including clear cell)
• Squamous cell carcinoma
• Glandular squamous cell carcinoma
• Undifferentiated cancer

It depends on the type of uterine cancer how long people live with it, how quickly metastases occur, and what treatment needs to be used. The more organized the cells are, the more similar they are to normal endometrium, the slower the tumor grows and the better the prognosis.

All endometrial tumors have their own growth characteristics. According to this parameter they are divided into three groups:

• with exophytic growth (95%) – growing into the uterine cavity
• with endophytic growth – growing into the thickness of the uterine wall
• mixed

As the disease progresses, exophytic tumors often become mixed and endophytic, which greatly increases the risk of metastases.

Once a diagnosis of endometrial cancer is made, its stage is determined. The following stages of endometrial cancer are distinguished:

Professor's Surgical Clinic Maka-Med SERVICES GYNECOLOGY ENDOSCOPIC GYNECOLOGY Uterine cancer

Cervical cancer vaccine

TREATMENT OF CERVICAL CANCER by STAGE

Pregnancy after conization of the cervix - Pregnancy planning

Cervical erosion after childbirth

Sources: http://womanadvice.ru/eroziya-sheyki-matki-posle-rodov, http://orake.info/rak-matki-posle-rodov/, http://litvar.ru/zdorove/1318-u -menya-rak-matki.html

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Pregnancy and cancer

Why do cancer develop in pregnant women?

Many scientists, studying the similarity of embryogenesis and oncogenesis (the formation of cancer cells), came to the conclusion that these processes are very similar. Therefore, quite often the immune and hormonal background of a pregnant woman, which is favorable for the fetus, becomes fertile ground for malignant growth. However, pregnancy itself is in no way the cause of the formation of cancer cells.

Risk factors

The likelihood of developing cancer in an expectant mother depends to some extent on the presence of the following risk factors:

late pregnancy (cancer incidence increases with age);

Living in an area with poor ecology;

Difficulties in diagnosis

Cancer in the early stages is mostly unnoticed. Moreover, if pregnant women experience any unusual symptoms (weakness, soreness and hardening of the mammary glands, changes in taste, nausea, pathological discharge from the genital tract), everything is attributed to an “interesting situation.” In addition, even if some “oncological” suspicions arise, it is not always possible to fully examine a pregnant woman, since this can negatively affect the baby (for example, X-ray examination methods, CT, MRI cannot be used).

Cancer and pregnancy

The behavior of the tumor in the body of the expectant mother is determined by various factors. The rate of progression of the malignant process is significantly influenced by the duration of pregnancy. Thus, cancer diagnosed in the first trimester is more prone to active growth and metastasis. Well, with a malignant tumor discovered in the last months of pregnancy, the course of the disease is usually more favorable.

The specific effects of cancer on pregnancy and its prognosis depend on the stage at which the cancer is diagnosed. With a widespread malignant process, the following complications may develop:

During pregnancy - miscarriage, intrauterine asphyxia, premature birth, anemia.

During childbirth - a mechanical obstacle to natural childbirth (tumors of the genital organs), weak labor activity.

After childbirth - bleeding (especially in acute leukemia).

The impact of cancer on the fetus

The presence of a malignant process in the mother’s body is not an obstacle to the birth of a healthy and full-fledged child. The possibility of tumor metastasis to the placenta and fetus exists, but such cases are rare and occur mainly in melanoma (skin cancer). Pregnant women with blood cancer can also rest easy, since with leukemia the probability of developing a similar disease in the baby is no more than 1%.

Features of treatment

Treatment of cancer in an expectant mother is a rather serious ethical problem, since if a malignant tumor is detected before 12 weeks of pregnancy, the woman is recommended to have an abortion in the interests of preserving her life. If the period is longer, then the probability of carrying the baby to viable age (28 weeks) with minimal losses for the mother’s health increases. Therefore, each specific case is considered separately, the prevalence and dynamics of the malignant process, and the woman’s condition are assessed.

Chemotherapy, hormone therapy and radiation therapy during pregnancy are contraindicated, as these treatment methods can cause severe fetal malformations and even the death of the unborn baby. All that remains for doctors is surgical removal of the tumor (with the obligatory use of other types of treatment after childbirth) or expectant management.

The patient should also know that termination of pregnancy does not stop the growth of the tumor; it is necessary for the immediate start of comprehensive cancer treatment. It is also important that abortion is a severe stress for the body, hormonal and immune systems of a woman; the course of the malignant process does not become any more favorable after such a serious ordeal. Therefore, abortion cannot be considered a panacea; without treatment, the tumor will not “resolve.”

The final decision to continue the pregnancy, of course, always remains with the patient, since after undergoing serious surgical treatment, radiation and chemotherapy, doctors cannot guarantee a woman 100% motherhood in the future.

Prevention

Cancer prevention in expectant mothers means, first of all, planning pregnancy with a full examination before its onset. The list of mandatory measures should include not only a gynecological examination, cytology and infectious disease panel tests, but also the following:

colposcopy, ultrasound of the reproductive organs;

Clinical blood test with formula, determination of biochemical blood parameters;

Testing for the presence of papillomavirus infection in the body (especially oncogenic types of the virus);

Consultation with a mammologist, ultrasound of the mammary glands (especially if the mother is 35 or more years old), this study can also be carried out during pregnancy;

Ultrasound of internal organs, lymph nodes;

Consultation with an endocrinologist, if necessary, ultrasound of the thyroid gland.

In addition, it is better to discuss any complaints regarding digestion, hormonal disorders and even moles on the skin with your doctor in advance. It is especially important to do all of the above for women with risk factors.

And the main thing that is necessary in the case of diagnosing oncology in a pregnant woman is a responsible attitude towards one’s health, a sober assessment of the situation, and listening to the doctor’s recommendations. “Cancer” is a very scary and unpleasant word, but not a death sentence at all.

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One comment

Hello, I am interested in one question. I was diagnosed with a terrible disease: leukemia, blood cancer. But we are thinking about the child. Will my illness harm my unborn baby or will it be passed on to him? I want a child and my husband really wants it, but I am afraid for the future of my child. Thanks for the reply earlier. It's very important for me to know this

Why is there cancer after childbirth?

mammary cancer. Women Health

Why do 2 liters of fluid accumulate in the lungs? A 67-year-old woman has breast cancer, diagnosed in 2005. The breast has undergone changes (decomposes), it is treated with folk remedies.

The liquid will accumulate faster and faster. I saw people who were brought in for a puncture literally after 2 weeks:(((. So find contact with the hospital where they will pump her out. Sometimes they do this right in the waiting room - pump her out, rest for a couple of hours and go home. But more often you have to go to the hospital for day.

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Breast cancer: after mastectomy. Prosthetics and breast surgery.

Girls, hello everyone! When I was tested at 21 weeks, I was diagnosed with human papillomavirus - and the doctor, when registering me, also looked at me and said that I might have it - she identified it even during the examination. Last spring I tested for all infections - everything was clean. According to the doctor, it is impossible to treat during B - now they have prescribed Viferon suppositories according to a long scheme and that’s all. And I read that there is, although minimal, the risk of infection of the child during passage through the birth canal. A.

When should you start going to the doctor who will deliver the baby?

I want to consult. I will most likely give birth either in Sechenovka or in Oparin, because my insurance pays for contracted births in these maternity hospitals (still in 7, it is closed for washing, in 29 and 25, but I am inclined to favor of the first options, because friends gave birth there and were satisfied). The birth contract is issued after 36 weeks. My friend, who had a difficult birth, says that it is better to choose a doctor much earlier. And from the 20th week onwards, go to the doctor you see.

If through the insurance company, then they and Sechenovka have a special policy that includes care from 20 weeks and childbirth. I just found out about it too late.

Bleeding!. A child from birth to one year

Bleeding.. :((((Damn. 1.5 months after giving birth. There has been no discharge for two weeks. And here.. It was smearing for two days, and today the blood started.. What should I do? Go to the doctor? At best, I’ll see you in a week :((. Could this be cancer? I won’t be able to feed the little one.

Cervical erosion. Women Health

Today my sister came in tears. She visited a gynecologist and was told that she had erosion. Large sizes. And that she would probably develop cancer and that she would most likely not be able to have children. They ordered tests, and she passed them. They also sent me for an ultrasound of the pelvis. The doctor was in a paid clinic. My sister has not given birth yet. What are they doing now about erosion? I had it and I burned it with liquid nitrogen. And then many doctors scolded me. Maybe go to another doctor?

It’s bad that our “mega-experienced” district gynecologist did this on the first day of my month, but then my cycle was restored for a year, apparently from fright.

No children yet, unfortunately. I hope this is not the reason.

After removal of the uterus. Women Health

Dear women, share your impressions of those who have undergone surgery to remove the uterus (I am facing this due to a huge fibroid). What are the impressions and consequences? Aren't you getting fat? I heard that after this you can become hooked on hormones for the rest of your life.

Anyone who has to get fat gets fat anyway, but this has nothing to do with having the uterus removed.

They get hooked on hormones - with ovarian pathology, with serious ones.

Here, my friend, for example, has exactly this pathology. And she tried it on hormones (expensive, but she didn’t gain much weight, by the way), and now I recommended homeopathy to her, and she is satisfied and happy.

If there are problems, then you need to think, why bother yourself in the meantime?

Factors influencing the sex of the offspring. Planning a pregnancy

Interesting SCIENTIFIC article in the magazine :) “Science and Life”. True, it’s old, 2003. Why are more boys born after the war? Why do men whose work involves long expeditions mostly give birth to daughters?

Why does the likelihood of having a girl increase as parents age?

Why do more and more girls come into the world as the number of births increases?

Why are there more girls among illegitimate children than among married children?

Why do unhealthy men (cancer, heart attack, radiation sickness, diabetes, etc.) give birth to so many more boys than girls?

Women's breast health: 5 numbers that everyone needs to know.

Why is breast cancer given special attention, since there are many terrible diseases in the world? Everything is very simple: this is the most common cancer in women, from which they still die (in Russia - 20 thousand women a year) and which is successfully treated in the case of an early diagnosis. In order to reduce mortality and help the maximum number of patients, all conditions have been created today: the country has enough o.

My mother-in-law has breast cancer and is currently in... Women Health

My mother-in-law has breast cancer and is currently in the hospital, having undergone surgery. Tell me, how can you find out if you have cancer? if nothing bothers you. (and when you get sick it will be too late) What tests to take or what specialists to see.

And further. I decided for myself that ANY non-absorbable tumor must be removed, because... there is a possibility of it becoming malignant over time. There are cases where degeneration occurred after a puncture for a biopsy. Again, my rule: if there is something to pierce, then there is something to cut out. Therefore, I minimize the time between biopsy analysis and surgery. Of course, all these are my cockroaches, based on personal sad experience.

Topic of the week: breast cancer

Breast cancer is the most common malignant cancer in many countries around the world. The breast is made up of the same tissue in men and women, so breast cancer also occurs in men (in approximately 1% of cases). In the early 90s, thanks to screening measures (periodic examinations by specialists, routine mammography), mortality from breast cancer began to decline. Meanwhile, it is currently the leading cause of death from.

We all walk under God. About yours, about your girl’s

The famous singer has cancer, and the months are counting. And I have my own statistics. Pregnancy is about forty: a friend at 38, 3 months after birth, breast cancer, 12 years in remission. A friend of mine, a year after giving birth to breast cancer at 37, died 5 years later, and has been gone for 6 years. A friend gave birth at 40, blood cancer during pregnancy, died 2 years later, has been gone for 4 years. This is from a close circle.

Why did God punish? (about oncology). About yours, about your girl’s

They found metastases in my mother, everything is very serious. Dad is killed, trying to understand why he or mom have sinned so much in life, why God sent this to them. Why “all people are normal, but a curse was sent to them.” Mom is 62 years old. Breast cancer, for the second time (yes, they checked, yes, they did chemotherapy, yes, they cured it. And suddenly, yes, they will do chemotherapy again, doctors have already been found, the prognosis is bad, there are a lot of metastases). The question is not about cancer. Question about how to talk to dad. He tries to remember his sins before God. What he.

ER or Caesarean. Pregnancy and childbirth

Girls, I’m still like China before giving birth :) But the question is already gnawing at me. I’ve been reading this conf for several years now, and threads often pop up from which it’s clear that the majority here is for EP and almost categorically against the CC. But judging by the experience of my friends, I am still inclined to believe that if I had a choice, I would choose a CS!! For most girls, the birth process was very traumatic and ultimately ended in a CS. How childbirth will affect babies in the future is still unclear. But for some reason it seems easier to me.

So - my EP was not the easiest, but with all the inductions, on the second day I jumped like a goat around the department and at 5 in the morning I woke up my sister in the nursery and demanded the child into my room. Despite all the problems, on the 3rd day I already said that the second one can be tolerated, but immediately with him.

Together with me in the prenatal room there was a girl who was taken for an emergency CS. Moreover, they took him away at the moment when it became clear that the baby WOULD get worse in the future. that is, not already, but it will happen, you understand? so then everything depends on the team of doctors and their attentiveness. If you have problems, they will give you a CS, if not, you will give birth yourself and will carry the baby in your teeth on the first day)))

Childbirth is over. What happens to a woman who is breastfeeding and not so much.

Restoring the body after childbirth: how and in what time frame.

Why breast cancer may occur

Why breast cancer may occur. How not to be late

Progesterone stimulates the development of glandular elements of breast tissue: under its influence, the terminal vesicles increase in volume, become larger and larger. At this time, the woman feels engorgement and slight soreness in her breasts. 2-3 days after birth, the pituitary hormone prolactin, which is responsible for milk production, comes into play. Does breast size affect lactation? There is no direct relationship between breast size and milk supply. The hormonal background of a woman is much more important. The amount of glandular tissue is inherent in us by nature and does not change throughout life. During pregnancy and lactation, the amount of glandular tissue also does not increase, it simply becomes larger.

Erosion. Pregnancy and childbirth

Girls, please tell me. Has anyone become pregnant with cervical erosion? The fact is that it seems like a plan to start getting pregnant right away. month. I took tests on this, everything seemed to be fine, only there was erosion, but the doctor somehow did not insist on treatment, but said that if you really want to give birth, then give birth, and then come back after the birth and we will treat, because treatment will take from 3 to 6 months. But I don’t know what to do, because I kind of want the second one quickly, because... I'm afraid what if.

the breasts became hard. Breast-feeding

Girls, tell me what to do? My sister gave birth a week ago. She started breastfeeding and her breasts became hard. Pumping doesn't help

Sex after childbirth. Why does it hurt? Contraception and sex.

Why does erosion often appear after childbirth?

The occurrence of cervical erosion after childbirth, the need and methods of treating erosion

Should this be the case or should I consult with my doctor?

Thank you in advance for your response.

Nodule on the thyroid gland! Medicine and health

A friend called, just crying: she had an ultrasound of the thyroid gland, they found a 3mm nodule. She is terribly suspicious, she had a serious suspicion of a breast tumor - but everything turned out fine, it was a benign fibroid. She has a doctor, but will she go to him only on Monday? How serious is this? She is 39 years old.

HPV 16. Pregnancy and childbirth

This is my second pregnancy. 11 weeks. I got tested and today I found out that I have positive HPV 16 (human papilloma virus). The doctor didn't seem to say anything about this. She just told me to read about it on the Internet and treat the erosion after giving birth. And after reading, I’m now terribly afraid, because... a lot of unpleasant things have been written about this HPV. Girls, if anyone has also tested positive for the virus, please tell us your opinion on this issue. How does anyone feel about this?

again about nutrition on the eve of childbirth. Pregnancy and childbirth

We recently discussed it, but they just sent me a list, I don’t know how much truth there is 🙂 maybe someone can tell me from their own experience A month before the birth A month before the expected birth, it is recommended to remove animal protein from the diet - meat, fish, eggs, butter , milk. What remains are fermented milk products, plant foods, water porridge, baked vegetables, fresh juices, mineral water, herbal teas. (But you need to be careful with herbs. For example, you can’t drink herbs that include thyme because it stimulates.

I think that you should listen to your body in everything, but you need to limit yourself a little.)

Have an easy pregnancy and childbirth.

How long does it take for weight to come off after childbirth? Losing weight.

Girls, I want your feedback. How long did it take for someone to start losing weight after giving birth? And how long did it take for your tummy to tighten? And what did you do for this? I can’t play sports, I have no one to leave my children with! It’s been 2.5 months now and there’s been zero change. (I eat vegetables and fruits). I will be grateful for your answers.

I lost weight in the first months, because... There was no time to eat, because of this the milk disappeared. If you want to breastfeed, don't worry about weight just yet. You'll figure it out after finishing!

Nervous wife. Family relationships

Dear women, help my wife get her nerves in order (with advice). After giving birth, she became unbearably unhealthy and nervous. I'm waiting for answers, Tanya's husband.

I even went to see my mother for a couple of days. We don't have a child

slept at night for 2.5 months, so I had everything

like in fog. This will pass, the first time is very difficult.

Be patient, your wife needs you more now,

than ever, even if she doesn’t tell you anything about it

speaks. Believe me, she really appreciates any help from you,

her whole life has been turned upside down, and she needs time,

to understand these changes. She has no time for you now, this

It’s a shame, but this is not forever, very soon everything will start to get better.

Give her a rest and wait. Look at your child.

You have such a miracle growing, and you are quarreling!

Dear Tanya’s husband! Advice won't help here! We need to help here!

Do you take care of the child at night, allowing your wife to sleep at least a couple of times a week? Do you often take days off to help? Does your wife always have fresh flowers in a vase or on very big holidays? Do you often take on household chores? Do you often tell your wife that you love her?

If in general, no, it seems to me that you are in vain coming here for advice.

Freezing. Breast-feeding

When feeding and during hot flashes it freezes wildly. Am I the only one who is so wrong?

Why do animals get sick? Pets

I'm in quiet shock. My cat recently died. It burned down in 3 days - they couldn’t do anything - they said it was too late. It was not the cat who died who had cancer and whom we were treating, doing chemotherapy and so on, but a completely healthy and cheerful one from my point of view. my favorite, who galloped like a moose and was only 3 years old. Presumably it was also cancer, since according to the ultrasound, almost all of his internal organs were damaged. How can this be? I just do not know. My second cat has about six months left or so.

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Unfortunately, today the number of cancer diseases is steadily growing. It is not surprising that some women are going to give birth after suffering from cancer (we wrote about cancer during pregnancy earlier), because the average age of first birth is constantly increasing. Today, data suggests that women began giving birth to their first children at an average age of 30.

Indeed, before this age, women often build a career, arrange the material aspects of their lives, and only after achieving their goals do they prepare to become mothers. At the same time, the age of cancer is constantly decreasing, and their frequency, on the contrary, is increasing. Thus, the chances of getting cancer before the birth of your first child are becoming increasingly higher.

What are the prospects for pregnancy after cancer?

Of course, in the treatment of cancer, drugs and techniques are used that leave a negative mark (see) on the woman’s health. These factors also affect human reproductive functions. In addition, depending on how long ago the treatment was given, there may still be toxic effects that could affect the development of the fetus. A number of cancer therapy methods involve a ban on pregnancy for a certain period (for example, after radioiodine therapy it is not recommended to become pregnant for a year).

Statistics show that more than 80% of women who become pregnant after cancer have had their pregnancy terminated. Indeed, it is very scary to risk the health of your unborn baby. At the same time, in cases where women carried a pregnancy to term, the birth of healthy babies was not uncommon. Moreover, healthy children were born even when pregnancy was carried out (the first such case was registered in 1946; doctors did not know about the patient’s pregnancy, and attributed the absence of menstruation to hormonal imbalances, continuing treatment).

In many cases, recommendations after cancer therapy state that it is necessary to wait at least two years before planning a pregnancy. Statistics have data on compliance and violation of this recommended period.

Thus, among 62 women who became pregnant after cancer treatment and did not terminate the pregnancy, 27 gave birth to completely healthy children, and the pregnancy occurred earlier than the recommended two-year break. Those women who became pregnant almost at the end of this period carried and gave birth to children much easier than those who became pregnant within six months after the course of therapy. Thus, it is quite possible to become pregnant before two years have passed, however, for greater confidence, it is better to stick to this period.

There is an opinion that becoming pregnant after cancer is strictly contraindicated. It is believed that those medicinal substances, as well as techniques such as radiation therapy, etc. make genetic changes, so even after many years, pathologies can affect the fetus.

In fact, this statement is wrong, which is confirmed by statistics. In addition, in each case, the indications and contraindications are purely individual, since patients receive different treatments, the cancer is also at different stages and responds differently to therapy.

Today, scientists around the world are working in a fundamentally new direction, which makes it possible to preserve the genitals as much as possible during cancer treatment. Innovative medications are being developed, organ-preserving operations are being carried out, and new methods of radiation therapy are being introduced. In addition, there is such a technique as the advance selection of intact genetic material - the essence of the technique is that even before the start of cancer treatment, genetic material is selected from the patient, and then stored for the entire period of treatment and after it. Thus, with the help of artificial insemination, an initially intact fertilized egg can be implanted into the uterus.

Pregnancy control after cancer

Whatever the period after cancer, a woman who has suffered from cancer and then became pregnant needs careful and qualified medical supervision. First of all, it is necessary to undergo all examinations in a timely manner, closely monitor your general health, and monitor changes occurring in the body.

Naturally, pregnancy control in a woman who has had cancer is much more thorough than in the standard case. You should be prepared for this and not worry about it. In general, it is important to have a positive attitude, to understand that the changes in the body that occur in connection with pregnancy are the norm, but they should be controlled.

Where can I get diagnosed and treated for cancer?

The pages of our website provide information about a variety of medical institutions from European and other countries where diagnosis and treatment of various forms of cancer can be carried out. For example, these could be centers and clinics such as:

The Israeli Helen Schneider Hospital is widely known as a clinical base for the practical application of the latest medical achievements. In its work, the hospital uses only modern equipment, as well as the most modern technologies and effective drugs to combat cancer.

Why do cancer develop in pregnant women? Research examining malignant processes during pregnancy is insufficient, not because cancer during pregnancy is rare, but also due to the moral and ethical aspects of the problem. But, despite this, there are works that show that the processes of carcinogenesis (cancer development) and embryogenesis (development and formation of the fetus) are very similar, therefore the immune and hormonal background of a woman, favorable for the fetus, becomes just as favorable for malignant processes.

The most common cancers during pregnancy are: cervical cancer (12 cases per 10,000 pregnancies), breast (1 case per 3,000 pregnancies), ovarian (1 case per 18,000 pregnancies), colon (1 case per 50,000 pregnancies ) and stomach, thyroid cancer and hematological diseases.

Risk factors are identified: late pregnancy (cancer incidence increases with age), women's hormonal imbalances, bad habits (smoking, alcohol), heredity.

The presence of cancer in the mother’s body is not an obstacle to the birth of a healthy child - cancer is not transmitted during pregnancy or childbirth

It is important to note that the presence of cancer in the mother’s body is not an obstacle to the birth of a healthy child - cancer is not transmitted during pregnancy or childbirth! But you can find a description of isolated clinical cases of tumor metastasis to the placenta and fetus - mainly in melanoma (aggressive skin cancer), small cell lung cancer, non-Hodgkin's lymphoma and leukemia (in 1% of cases, leukemia can be transmitted to the child).

Cancer in the early stages is mostly asymptomatic, but nonspecific complaints are still noted: weakness and fatigue, lack or loss of appetite, nausea and vomiting, as well as the appearance of lumps in the mammary glands and discharge from the genital tract - all this is easily correlated with pregnancy including.

Safe diagnostic methods during pregnancy are endoscopic (gastro- and colonoscopy with sedation and biopsy), ultrasound and MRI, which do not emit X-rays and, therefore, do not have a teratogenic (damaging to the fetus) effect. In some cases, the use of X-rays and computed tomography with the use of protective screens is allowed.

The impact of cancer on the course and prognosis of pregnancy, as well as on the life of the mother and fetus, depends on the period of pregnancy and at what stage the cancer is diagnosed, which also determines the possibilities for therapy. Tactics are determined only individually and depend on the type and stage of cancer.

If the disease is diagnosed before 12 weeks (1st trimester), most of the specific treatment methods at this time are dangerous for the fetus, since there is a high probability of disruption of its development and/or the risk of the formation of abnormalities of internal organs. Therefore, at this stage, the possibility of terminating the pregnancy is discussed with the patient in the interests of preserving the woman’s life, or the possibility of delaying the start of therapy until the viable period of the fetus (28 weeks) for the purpose of delivery, or until the 2-3 trimester of pregnancy, when the main processes of formation of the internal organs of the fetus are completed. But even in this case, it is impossible to completely exclude an abnormality of fetal development during therapy. At the same time, increasing the waiting period for treatment may pose a risk to the mother's life.

Cancer treatment during pregnancy is complex. Surgery is considered the most common and safest method, especially after the 1st trimester of pregnancy, although each type of cancer has its own characteristics.

• For breast cancer - at any stage, it is possible to perform both breast-conserving surgery and mastectomy (removal of the mammary gland) with the possibility of performing a sentinel lymph node biopsy in both cases (with the help of a radiopharmaceutical, metastases in regional lymph nodes can be detected, but it is not recommended to use methylene for this procedure blue).
• For intestinal cancer, surgical treatment is possible both before and after 20 weeks of pregnancy, provided that the uterus and fetus are not involved in the pathological process and it is possible to preserve it; but in the case of colon cancer, we must remember that metastases to the ovaries during pregnancy occur in 25% of cases (versus 3-8% in the absence of pregnancy), therefore it is advisable to perform a biopsy of both ovaries during surgery, and bilateral removal - only in the case of histological confirmation of their involvement in the pathological process and only after 12-14 weeks of pregnancy, but even during these periods there will remain a high risk of miscarriage.
• For ovarian cancer, the scope of the operation, depending on the situation, can be minimal - removal of only the affected ovary - or standard, which involves removal of the uterus with both ovaries, in which case it is impossible to maintain pregnancy up to 24 weeks, and after 24 and closer to 36 weeks - caesarean section followed by radical surgery.
• Cervical cancer in the early stages IA-IB1 (tumor up to 2 cm) - conization (resection of the cervix) and trachelectomy (amputation of the cervix) with removal of regional lymph nodes, in more advanced stages - the issue of preoperative chemotherapy and delivery is decided to consider the possibility carrying out radiation therapy.

The decision on each individual case of pregnancy and cancer should be made only individually, after assessing the prevalence of the disease, the type of cancer and its dynamics, and the woman’s condition

As for chemotherapy, the situation with it is quite simple: when it is indicated (the recommendations and purpose of its implementation during pregnancy are similar to those in the absence of pregnancy), regardless of the type of cancer and its prevalence, preoperative or prophylactic (postoperative) is the main condition for its safe implementation for the mother and the fetus is 2-3 trimesters of pregnancy.

But radiation therapy is contraindicated throughout pregnancy and is possible only after delivery. Breastfeeding is also prohibited during the entire period of specific cancer treatment.

If we are talking about, then we need to take into account many factors: the volume and timing of specific treatment, chemotherapy drugs used in the regimen (for example, if a woman received targeted therapy in the postoperative period, then at least a year must pass before planning and pregnancy), the biology of the tumor - her hormonal status, because at the end of the main stage of treatment, antihormonal therapy is required for 5, and according to the latest recommendations - 10 years. In these cases, it is recommended to wait at least 2-3 years before planning pregnancy and to resume antihormonal therapy after the birth of the child.

These are general recommendations. The decision on each individual case of pregnancy and cancer should be made only individually, after assessing the prevalence of the disease, the type of cancer and its dynamics, and the woman’s condition. The decision must be made jointly (by the pregnant woman and a council of specialists); it is very important to explain to the woman that termination of pregnancy does not stop the development of cancer, but makes it possible to immediately begin complex treatment.

Prevention of cancer during pregnancy is, first of all, planning pregnancy with the necessary set of examinations before its onset.

Supported by:

The physiological process of pregnancy is aimed at giving birth to a healthy child. Malignant tumors without special treatment lead to a rapid fatal outcome. The combination of malignant tumors and pregnancy creates an extremely acute and dynamic clinical situation. The interaction of obstetric and oncological problems is inevitable, since pregnancy can have an adverse effect on tumor growth, and the tumor can have an adverse effect on the development and outcome of pregnancy. At the same time, ethical problems arise, since further continuation of pregnancy can worsen the already dubious prognosis of a malignant tumor, and its treatment can harm the unborn child or even terminate the pregnancy.

In most cases, pregnancy adversely affects the progression, growth and spread of cancer. It must be emphasized that priority should be given to mother's interests. Most clinicians adhere to this position. Pregnancy is characterized by a programmed disruption of hemostasis: an increase in blood levels of glucose, insulin, fatty acids and cholesterol. Pregnancy is considered an example of metabolic immunosuppression, which may predispose to cancer. However, in clinical oncology there is no evidence of an increase in the incidence of malignant tumors during pregnancy. It is possible that the immunosuppressive effect of pregnancy manifests itself in the long term.

Thus, In the clinic, two options are most likely: no effect of pregnancy on the tumor or worsening of the clinical course of the disease.

Malignant and benign tumors are observed in 0.27% of pregnant women. The combination of pregnancy and malignant tumors of various localizations occurs in 0.01-0.03% of cases. Most combinations with pregnancy occur with cervical and breast cancer (62%). The frequency of the combination of widespread gastric and rectal cancer (10.8%) is not much higher than that of rare sarcomas (7.1%). Next in decreasing frequency are ovarian cancer (5.5%), malignant lymphomas (4.9 %), thyroid cancer (2.4%), malignant melanomas (1.9%). All other malignant tumors are combined with pregnancy in 5.4% of cases.

The combination of malignant tumors and pregnancy raises many questions for specialists.

There is no shortage of specialized literature on the problem of cancer and pregnancy. However, there remains much more controversial than clear, and many issues have not received sufficient coverage.

Cancer and pregnancy. What effect do malignant tumors have on the course of pregnancy?

The occurrence, growth and spread of cancer is associated with various metabolic and immunological disorders, which can have an adverse effect on pregnancy.

As various studies have shown, there is an inverse relationship between the prognosis for the unborn child and the health of the mother from the stage of pregnancy at which a malignant tumor is diagnosed.

The prognosis for the child is more favorable if the tumor appears late - in the third trimester.

If cancer detected in the third trimester, this indicates that the growing tumor does not significantly affect pregnancy and fetal growth.

In cancer patients, the incidence of miscarriage and intrauterine asphyxia increases. Infant mortality in the 1st year of life is 25%, which is significantly higher than the average statistical data.

We must not forget about possible complications during childbirth and the postpartum period if the tumor is localized in the pelvic area.

Large, impacted tumors can create mechanical obstacles to natural childbirth.

• Infected, decaying tumors of the cervix or rectum are a possible cause of purulent-septic complications.
• At pheochromocytoma adrenal glands during childbirth, acute circulatory disorders and shock are possible.
• In patients with primary And metastatic Bleeding resulting in death has been described with liver cancer.
• At brain tumors, especially when they are localized in the pituitary gland, during childbirth there is often a rise in intracerebral pressure, resulting in severe neurological disorders.
• In patients with acute leukemia there is a violation of the blood coagulation system with the development of severe postpartum hemorrhages, of which 10 % are the cause of death on the 1st day of the postpartum period. Subsequently, septic postpartum diseases develop. Thus, malignant tumors adversely affect the course of pregnancy and childbirth at advanced stages. In uncommon forms of cancer, such an effect is not observed.

Is it possible to metastasize to the placenta and fetus?

The question of metastasis was raised back in 1866. A case of a malignant liver tumor in a pregnant woman was described. In a child who died 6 days after birth, an autopsy revealed metastases of an identical structure.

Over more than 100 years, only 35 cases of metastasis to the placenta and fetus have been described. Currently, 29 observations of tumor metastasis to the placenta without damage to the fetus and 6 cases of metastasis to the fetus have been published (including 2 with documented damage to the placenta). Observations of malignant melanoma, ovarian cancer, liver cancer, and kidney cancer are described.

It should be noted that in the literature there are no descriptions of metastasis of cervical cancer to the placenta and fetus. It is believed that placental and transplacental metastasis is influenced not by the proximity of the tumor to the uterus, but by its potential for generalization.

When metastases were detected in the placenta and/or fetus, all mothers died from cancer within the immediate period after delivery.

With metastases to the placenta, only 30% of children remained alive during the 1st year.

It is necessary to talk about the possible transmission of hemoblastoses from mother to fetus. In 1% of cases, children are diagnosed with the same disease as the mother with a fatal outcome.

Placental and transplacental metastasis is most common and is especially severe in malignant melanoma.

Clinical experience indicates that it is inappropriate to continue an early pregnancy when combined with malignant tumors, for the treatment of which radiation and (or) chemotherapy are supposed to be used.

Cervical cancer and pregnancy

Cervical cancer ranks first in the structure of incidence of malignant tumors of the female genital organs. According to summary data, among malignant tumors in pregnant women, cervical cancer ranks first: from 0.17 to 4.1 %.

Among the forms of cancer, exophytic and mixed forms of tumor growth predominate (in 74.3%), located in the ectocervix (in 89.2%), and bleeding (in 68.2%).

In the first trimester During pregnancy, the symptom of uterine bleeding is often regarded as an incipient miscarriage, in the second and third trimesters - as an obstetric pathology: previa or premature placental abruption. In many cases, pregnant women do not undergo a thorough examination of the cervix using mirrors; Cytological examination and colposcopy are rarely used. The situation is aggravated by an unreasonable fear of a biopsy. Cytological screening allows one to obtain information about the frequency of detection of cervical cancer among pregnant women (0.34%). At the same time, the frequency of pre-invasive cancer is 0.31%, invasive - 0.04%.

Currently, a two-stage diagnostic system is considered the basis for identifying early forms of cervical cancer:

1. cytological screening during gynecological examination;
2. in-depth comprehensive diagnostics when identifying visual or cytological pathology.

According to many clinicians, long-term pregnancy and the postpartum period have an adverse effect on the clinical course of cervical cancer.

One of the leading manifestations of tumor progression is a decrease in the degree of its differentiation. Another unfavorable factor is deep invasion of the tumor into the tissue of the cervix.

Reduced tumor differentiation and its deep invasion contribute to rapid spread beyond the organ. During surgery for a combination of cervical cancer and pregnancy, metastases are found in the regional pelvic lymph nodes 2 times more often.

The results of the study of cellular immunity indicate inhibition of cellular immunity already in the first trimester of pregnancy in patients with stage I of the disease.

Medical tactics in the treatment of pregnant women with cervical cancer are difficult to limit within the strict framework of a specific scheme. We cannot agree with the principle: treat cancer taking into account the stage and ignore pregnancy. A strictly individual approach is required, and the duration of pregnancy plays a significant role.

At cancer in situ cervix VI Treatment consists of termination of pregnancy and cone-shaped excision of the cervix. InIIAndIIItrimesters Diagnostic colposcopic and cytological observation is carried out. 2-3 months after delivery, a cone-shaped excision of the cervix is ​​performed.

At I.A. stages of the disease VI, II Extirpation of the uterus and the upper third of the vagina is performed.

At I.B. stages VI, IItrimesters of pregnancy and after childbirth extended hysterectomy is performed; in the postoperative period, with deep invasion and regional metastases, external irradiation is performed. INIIItrimester of pregnancy A cesarean section is performed followed by extended hysterectomy. In the postoperative period, external beam radiation therapy is used.

At IIA stages VI, II, IIItrimesters of pregnancy Extended hysterectomy is performed followed by external irradiation. After childbirth treatment consists of preoperative irradiation; in performing extended hysterectomy and performing remote irradiation in the postoperative period for deep invasion and regional metastases.

At II At the stage of the disease VItrimester of pregnancy and after childbirth Combined radiation treatment is carried out (intracavitary and external). You should not strive for artificial termination of pregnancy in the first trimester at stages II and III of the disease, since spontaneous miscarriages occur on the 10-14th day from the start of radiation therapy. If the PV stage of the disease is diagnosed inIIAndIIItrimesters of pregnancy, perform cesarean section and combined radiation treatment in the postoperative period.

At III stages of the disease VItrimester of pregnancy and after childbirth treatment begins with combined radiation therapy (intracavitary and external irradiation). InIIAndIIItrimesters of pregnancy Treatment begins with cesarean section followed by combined radiation therapy.

For women suffering from pre- and microinvasive cervical cancer and wishing to have children, it is possible to carry out functionally gentle treatment methods: electroconization, cryodestruction, knife and laser amputation of the cervix. In this case, pregnancy and childbirth do not adversely affect the course of the underlying disease. The relapse rate after organ-preserving treatment of initial forms of cervical cancer is 3.9%; relapse rate in the population is 1.6-5.0%.

The pregnancy rate after organ-preserving treatment of initial forms of cervical cancer ranges from 20.0 to 48.4 %.

Prolongation of pregnancy is advisable no earlier than 2 years after functionally gentle treatment of cervical pathology. Conducting vaginal delivery is not contraindicated. There was an increased incidence of miscarriage and premature birth compared to healthy women. There is a higher perinatal mortality rate (11.5%). An increase in the frequency of premature termination of pregnancy after organ-preserving treatment of cervical pathology indicates the need for preventive measures (antispasmodics, tocolytics, antiplatelet agents, bed rest). Delivery by cesarean section is carried out only for obstetric indications. Dispensary observation after undergoing functional-sparing treatment of initial forms of cervical cancer includes examination in the 1st year at least 6 times; in the 2nd - 4 times; in subsequent years - 2 times a year.

Uterine cancer and pregnancy

The combination of uterine cancer and pregnancy is rare for two main reasons: due to a significant decrease in generative function in these patients and the strong influence of progesterone on the endometrium, which prevents the development of atypical hyperplasia and endometrial cancer. Probably, fertilization, implantation of the fertilized egg and the development of pregnancy are possible only in the initial forms of endometrial cancer, when the tumor process in the uterus has not yet spread. In these cases, the prognosis after radical treatment is more favorable.

Malignant ovarian tumors and pregnancy

The frequency of combination of ovarian cancer with pregnancy does not exceed 1:25,000, and cancer of this location accounts for 3% of all ovarian tumors removed during pregnancy.

The question of the relationship between pregnancy and ovarian tumors is considered in several aspects:

1. about the possible influence of the state of reproductive function on the occurrence of ovarian tumors;
2. about the peculiarities of the course of an existing tumor process during pregnancy;
3. about the possibilities of preserving reproductive function after treatment for ovarian tumors.

Pain syndrome with a combination of ovarian tumors with pregnancy is observed in 48% of patients. During examination in early pregnancy, tumors are found in 25% of patients. Twisting of the tumor stalk is more common in pregnant women than in non-pregnant women and accounts for 29%.

The frequency of miscarriages after surgery for an ovarian tumor in the first trimester of pregnancy is 35%, in the second - 20%.

The combination of arrhenoblastoma with pregnancy is very rare. There was no indication of relapse associated with subsequent pregnancy. Therefore, it is recommended to carry out saving operations in the absence of signs of spread of the tumor process and subject to careful monitoring of patients, including determination of the level of 17-KS excretion.

Patients with estrogen-producing granulosatheca cell tumors often experience infertility, and if pregnancy occurs, miscarriages. In addition, childbirth is associated with bleeding from the tumor.

Based on the highest probability of relapse in the first 2-3 years after tumor removal, pregnancy during this period is undesirable.

When a malignant tumor is localized in one ovary in young women who want to have children in the future, it is recommended to perform unilateral removal of the uterine appendages with resection of the second ovary and greater omentum, followed by chemotherapy. The relapse rate with this treatment for initial forms of ovarian cancer is 9.1%; in the population - 23.4-27.0%.

The pregnancy rate after organ-preserving treatment in the specified volume reaches 72.7%.

Malignant breast tumors and pregnancy

Breast cancer occupies one of the first places among malignant neoplasms in women. In recent years, the incidence of the combination of pregnancy and cancer has increased.

There are two aspects to this problem: cancer among pregnant women and pregnancy with cancer. Breast cancer in pregnant women occurs in 0.03-0.3% of cases, pregnancy with breast cancer - in 0.78-3.8%, and in some reports this figure reaches 14%.

According to experimental data, changes in the body of rats associated with pregnancy generally inhibit the occurrence of mammary gland tumors, increase tumor differentiation and reduce the degree of malignancy.

In case of breast tumors diagnosed during pregnancy, deviations in hormonal homeostasis are characterized by hyperestrogenization, disruption of the rhythm of the menstrual cycle with the appearance of an unusual for physiological norm peak of LH secretion in the follicular phase and low levels of FSH in patients after abortion, hyperestrogenization in combination with hyperprolactinemia in cancer patients mammary gland, diagnosed during lactation, hypercortisolism in some patients.

Among the clinical forms of breast cancer, inflammatory ones predominate (in 15% of cases); rapidly metastasizing undifferentiated forms are often found, and differentiated ones are less common. A characteristic feature of the combination of pregnancy and breast cancer is the detection of the latter in patients with many pregnancies and births of the late reproductive period (35-44 years), who have a significant (5 years or more) break between pregnancies.

Another characteristic feature is the predominance of lobular forms among the morphological structures of the mammary gland and the severity of intracanalicular and myoepithelial proliferation in the tissues surrounding the tumor. There is a high frequency of previous hyperplastic and proliferative processes in the tissues of the gland, high levels of E 3 and progesterone.

If a morphologically confirmed malignant tumor of the mammary gland is detected, termination of pregnancy is indicated. After this, treatment is carried out according to the stage of the tumor.

Extragenital malignant tumors and pregnancy

Skin melanoma and pregnancy. It is well known that skin melanoma accounts for 1 to 3% of oncological diseases. Even less often, it is observed in combination with pregnancy. There is evidence of the influence of hormonal status altered by pregnancy on the pigment system, in some cases manifested in the activation of pigmented nevi. It has been established that in the cytoplasm of melanoma cells there are special receptors for estrogens, and rapid tumor growth and metastases have also been reported when taking estrogens. This suggests an adverse, tumor-promoting effect of pregnancy on melanoma. Clinical observations show that the combination of pregnancy and melanoma in most cases worsens the prognosis.

The prognosis for skin melanoma largely depends on the location of the primary lesion. The localization of the primary lesion on the body, in the head and neck area is unfavorable. Localization of melanoma in the upper and lower extremities has a more favorable prognosis. Survival of patients depends mainly on the stage of melanoma.

In clinical stage I melanoma, the 3-year survival rate for pregnant women is 65.2 ± 5.8%, for non-pregnant women - 70.9 ± 2.2%; 5-year - 44.4 ± 6.7% and 53.6 + 2.6%; 10-year - 26 + 7.4% and 43 ± 2.8 % respectively. Consequently, when clinical stage I melanoma and pregnancy are combined, long-term treatment results worsen.

In clinical stages II and III of the disease, the pregnancy factor does not have a significant impact on life prognosis.

A comparison of the survival rate of patients with stage I, in whom clinical manifestations of melanoma arose in the first half of pregnancy, with those in whom they arose in the second half and during lactation, showed that the course of the disease is significantly more complicated if melanoma arose in the second half of pregnancy. Perhaps the high level of estrogen and growth hormone observed during this period of pregnancy is important.

The above basic patterns of the combination of skin melanoma and pregnancy allow us to develop the following treatment tactics. In the first half of pregnancy in patients with I stage of the disease, with a favorable individual life prognosis There is no need to perform an abortion. Under anesthesia (preferably neuroleptanalgesia), the skin melanoma is widely excised according to the accepted technique. The obtained data from the morphological study and their analysis allow us to make more informed judgments about the prognosis of the disease. The patient and relatives should be encouraged to continue the pregnancy.

If the life prognosis is unfavorable, as determined by a combination of clinical and morphological signs, the decision to continue the pregnancy is made individually. You should not insist on either continuing the pregnancy or abortion. The decision must be made by the woman herself or her family. Information for relatives should not be dramatized, limiting itself to the fact that the course of any oncological process is completely unpredictable, and the disease poses a certain danger to the patient’s life. Pregnancy itself does not affect the course of the disease.

At II clinical stage melanoma in the first half of pregnancy at the first stage of treatment it is necessary to establish medical indications to termination of pregnancy, and then treat skin melanoma with metastases to the lymph nodes. This tactic is based on the fact that when terminating a pregnancy, the treatment result is slightly better; in addition, it creates the opportunity for additional treatment in the postoperative period.

At III clinical stage The first stage of treatment is to carry out medical abortion. It should be taken into account that maintaining pregnancy is a possibility of transplacental metastasis and manifestation of the teratogenic effect of chemotherapy drugs.

In the second half of pregnancy, at any stage of the disease, based on the interests of the child, all measures should be taken to carry the fetus to term.

Surgical treatment to the standard extent for stages I and II is carried out under anesthesia (neuroleptanalgesia). Additional treatment can be started in the postpartum period, provided the child is bottle-fed. If necessary, a caesarean section is performed according to indications.

At present, there is no direct data to establish the effect of pregnancy on the fate of patients after radical treatment for skin melanoma. Previous analysis has shown that pregnancy does not have a “protective” effect, and therefore pregnancy after treatment should not be recommended.

After radical treatment V I stage of melanoma in patients with a favorable prognosis for life Termination of pregnancy should not be recommended.

Patients with I stage with a poor prognosis and with II stage of the disease You can be allowed to have a child after experiencing the “critical” period - 6 years. In case of pregnancy that occurred in an earlier period, it is possible to establish medical indications for termination of pregnancy, and only the persistent desire to have a child and the second half of pregnancy serve as an obstacle. The patient and her relatives should be warned about all possible complications that may arise in this case.

Lymphogranulomatosis and pregnancy. The question of the interaction between lymphogranulomatosis and pregnancy is little studied in the literature. Pregnancy worsens the prognosis of the disease, even if it is interrupted.

In the case of complete clinical and hematological remission of lymphogranulomatosis for more than 2 years from the end of treatment, the issue of pregnancy can be resolved positively.

Among women with lymphogranulomatosis, pregnant women account for 24.7%. Lymphogranulomatosis most often affects women of childbearing age in 72%, and pregnancy occurs in 15-30% of patients.

Thus, there are two variants of the combination of lymphogranulomatosis and pregnancy: the disease may occur during pregnancy or it may occur in a woman with lymphogranulomatosis. Menstrual and reproductive functions in these patients may be impaired.

Irradiation of the para-aortic and inguinoiliac lymph nodes results in loss of ovarian function and amenorrhea in almost all young women. To preserve ovarian function, young women and girls undergo ovarian transposition. Subsequently, during irradiation, the ovaries are protected with a lead block 10 cm thick. The use of this technique makes it possible to preserve ovarian function by 60%.

Lymphogranulomatosis during pregnancy is somewhat more often diagnosed in the II-III trimester.

Diagnosis of lymphogranulomatosis during pregnancy is difficult, since subjective symptoms of the disease (itching, low-grade body temperature, increased fatigue) are interpreted by doctors as complications of pregnancy.

If malignant lymphoma is suspected, the scope of diagnostic procedures is determined depending on the stage of pregnancy. A puncture biopsy of a lymph node can be performed at any stage of pregnancy. Removal of the lymph node is carried out taking into account the duration of pregnancy and the patient’s condition. X-ray examinations are contraindicated.

The opinion that pregnancy negatively affects the course of lymphogranulomatosis is currently not supported by most authors. The number of spontaneous abortions, stillbirths and pathological births observed with this combination is the same as among healthy women.

Medical tactics regarding pregnancy in patients with lymphogranulomatosis require strict individualization. When deciding this issue, it is necessary to take into account the duration of pregnancy, the nature of the disease, prognostic factors and the desire of the patient. If pregnancy is detected in patients who have not yet undergone treatment, or the simultaneous development of the disease and pregnancy in the first trimester, it is advisable medical abortion, which will allow a full examination of the patient and begin treatment.

In the acute course of the disease, including relapse, in the second and third trimesters of pregnancy, initiation of treatment during pregnancy, termination of pregnancy by cesarean section or labor stimulation at 7-8 months are indicated. One should take into account the fact that intensive polychemotherapy or irradiation of the para-aortic and inguinal-iliac areas has an adverse effect on the fetus. Chemotherapy with cytostatics should be carried out with extreme caution.

In patients with I -II stage lymphogranulomatosis, in a state of complete clinical remission for 3 years or more, pregnancy can be saved.

Patients with III - IV stage of the disease preferably Do not continue the pregnancy.

The active course of the disease in the first 2 years indicates a poor prognosis, so patients are advised to abstain from pregnancy or terminate it in a timely manner.

The adverse effect of lactation on the course of lymphogranulomatosis has not been established. However, given the large load on the body of a nursing mother, especially in cases where she is undergoing specific treatment, it is advisable to refrain from breastfeeding.

Thyroid cancer and pregnancy. Currently, thyroid cancer accounts for about 6% of all human malignant diseases. The increase in the incidence of thyroid cancer occurred among women, mostly young women. According to the literature, thyroid hormones play an important role in the occurrence and maintenance of pregnancy. Any dysfunction of the thyroid gland has an adverse effect on pregnancy. In turn, it leads to significant changes in the thyroid gland: its volume increases, and the proliferation of thyroid hormones in the blood increases. Pregnancy can provoke the development of thyrotoxicosis and nodular forms of goiter.

Thyroid cancer has a number of features. Cancer of this location, especially its highly differentiated form, is observed in women of childbearing age and is not accompanied by hormonal disorders. These forms of thyroid cancer are characterized by a slow progression. At the same time, women experience repeated pregnancies, childbirth, they breastfeed, and only later are they diagnosed with a malignant tumor of the thyroid gland.

The ten-year survival rate for papillary cancer is 90%, and in young patients it is even more than 90%. Clinical experience also indicates a relatively benign course of thyroid cancer during pregnancy, due to the fact that papillary and follicular forms of thyroid cancer, even in the presence of regional metastases, proceed favorably. The five-year survival rate is 93.3%. The prognosis for medullary squamous cell carcinoma is extremely unfavorable.

If differentiated thyroid cancer is diagnosed during pregnancy and radical surgery is possible, then the pregnancy can be saved. In this case, in the first and second trimesters, one should start with surgical intervention, and in the third, surgery should be performed after delivery.

Malignant brain tumors and pregnancy. The combination of pregnancy and brain tumors is relatively rare. The frequency of this pathology ranges from 1:1000 to 1:17,500 births. There is also evidence that in approximately 75% of cases of brain tumors in women of reproductive age, the first symptoms of the disease appear during pregnancy. Most reports indicate a negative effect of pregnancy on the course of brain tumors. The progression of the clinical manifestations of a brain tumor during pregnancy is explained by endocrine, electrolyte, hemodynamic and other changes that cause sodium and water retention in the body and an increase in intracranial pressure. There is also evidence that pregnancy can even stimulate the growth of meningiomas and glial tumors.

The tumors most prone to rapid progression during pregnancy include vascular tumors.

Brain tumors are a contraindication to continuing pregnancy. If the brain tumor is removed, then the question of continuing the pregnancy is decided individually depending on the morphological type of the tumor and the woman’s health condition.

Leukemia and pregnancy. The combination of leukemia and pregnancy is relatively uncommon. Pregnancy is especially rare in patients with acute leukemia. The comparative rarity of the combination of leukemia and pregnancy is explained by leukemic infiltration of the ovaries and tubes and functional amenorrhea.

There is a prevalence of the combination of pregnancy with chronic leukemia, mainly myeloid. According to most authors, pregnancy in patients with chronic leukemia does not have an adverse effect on its course. There is also an opinion that pregnancy improves the course of leukemia due to increased release of ACTH. Some authors draw attention to the fact that pregnancy with acute leukemia often ends in premature birth, less often - intrauterine fetal death, spontaneous abortion or death of patients before delivery.

In some cases, the course of pregnancy in acute leukemia is not disrupted, and it ends with urgent birth. The reason for the uncomplicated course of acute leukemia during pregnancy and terminal exacerbation in the postpartum period is explained by the fact that the fetal bone marrow compensates for the mother's hematopoiesis, while others explain this by the hyperfunction of the anterior pituitary gland and adrenal cortex in pregnant women.

With chronic leukemia, the prognosis for the mother is slightly better than with acute leukemia. Chronic leukemia should be treated in the same way as in the absence of pregnancy. The exception is the first trimester. Prescribing chemotherapy during this period can cause significant disturbances in fetal development. In this situation, it is better to terminate the pregnancy.

Malignant tumors of the urinary system and pregnancy. In women of childbearing age, tumors of the urinary system are extremely rare. The most common tumors are kidney tumors, among which hypernephromas predominate.

The diagnosis is made equally often in the second and third trimesters of pregnancy and in the postpartum period (26, 29, 26%, respectively). The most common clinical symptoms are pain in the lumbar region (64%) and hematuria (36%). If the tumor process proceeds without significant complications, one should strive to bring the pregnancy to the due date, when the fetus becomes viable, and perform a cesarean section and nephrectomy. If serious complications arise that require emergency interventions, the pregnancy is terminated and a nephrectomy is performed (the optimal period for the latter is the interval between the 12th and 36th weeks of pregnancy).

Malignant adrenal tumors and pregnancy. Malignant tumors of the adrenal glands are combined with pregnancy in a ratio of 1:12, which is 8.3% among women with malignant tumors of the adrenal glands. The histological type in half of the cases is adenocarcinoma, and in the other half - malignant pheochromocytoma. Pheochromocytoma often manifests itself in early pregnancy with symptoms of high arterial hypertension.