Management principles of head and neck cancers during pregnancy: a review and case series.
Head and neck cancers during pregnancy are rising in incidence. Clinicians need to be aware of the principles of managing these cases. This paper is a review of the literature of head and neck cancers during pregnancy with a short case series of six non-thyroid pregnancy-associated cancers treated by a head and neck oncology surgeon. The age range is 20-34 years. Tumour types include carcinoma of the tongue, nasopharynx, maxillary sinus, parotid gland, subglottic region, and the neck. Five patients were treated surgically and four were treated with either chemotherapy or radiotherapy. Both foetal and maternal death occurred in two cases. The range of follow-up is 15 months to 14 years. Managing head and neck cancers during pregnancy requires the addition of a pregnancy-related layer of understanding to the armoury of existing specialist knowledge, encompassing a triad of effects, (i) the aetiological effect of pregnancy on cancer, (ii) the direct and indirect effects of cancer on pregnancy, and (iii) the effect of diagnostic and treatment modalities on pregnancy. Consideration must also be given to the ethical dilemmas of decision making.
Atabo
Adigo
A
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Nottingham, Queen's Medical Centre Campus, Nottingham NG7 2UH, United Kingdom.
Bradley
Patrick James
PJ
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy*; D011256:Pregnancy Outcome; D011379:Prognosis