Managing cancer during pregnancy: what evidence do we have?

The diagnosis of cancer during the course of pregnancy is a challenging clinical situation both for the patient and the treating physicians. Given its relative rarity, evidence remains scarce as it is practically impossible to perform large prospective clinical trials. Another critical issue is the potential conflict between maternal and fetal wellbeing: this could result in undertreating pregnant women for fear of fetal toxicity, or in offering therapy that could result in fetal morbidity and mortality. While there are some general guidelines that can be applied for all tumor types, each disease has specific features that should be considered. In this review, we will consider the available evidence for managing pregnant women with cancer to provide some guidance for physicians dealing with these patients.