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A cancer diagnosis during pregnancy doesn't have to mean ending the pregnancy. Experts at a German oncology conference outlined how gestational age, cancer type, and treatment urgency should guide clinical decisions. While surgery is broadly safe across trimesters, chemotherapy timing matters greatly — and targeted therapies, immune checkpoint inhibitors, and HER2 agents should generally be avoided throughout pregnancy.
Cancer during pregnancy is rare but rising — and clinicians need a clear framework to act fast without putting mother or baby at undue risk. At the annual meeting of the German Society for Hematology and Medical Oncology, Dr. Mihada Bajrami Saipi walked through the key diagnostic and treatment considerations for this uniquely complex scenario. Melanoma, breast cancer, and cervical cancer top the list of most common malignancies seen during pregnancy.
On the imaging front, ultrasound and MRI without gadolinium contrast are the go-to tools. CT is considered safe from 18 weeks, but caution is warranted earlier given critical windows of fetal organogenesis (weeks 4–10) and CNS development (weeks 10–17). PET/CT is not recommended for routine use.
Key Takeaways
Why it matters: With more people delaying pregnancy, cancer-in-pregnancy cases are increasing. Clinicians need to balance treatment urgency against gestational timing — because, as Dr. Bajrami Saipi put it, "a cancer diagnosis during pregnancy does not necessarily mean the end of the pregnancy."
