Cancer in pregnancy, although thankfully a relatively uncommon occurrence, presents physicians and their patients with a major dilemma. The urge to use the highest tolerable doses of chemotherapy, high doses of irradiation and surgery has to be weighed carefully against their risks to the unborn baby. This book is the very first to attempt to quantify these risks and provide physicians with a core of knowledge that will be very relevant to making sound clinical decisions in the face of sometimes conflicting interests. The volume evaluates the results of the Motherisk Program, which was set up specifically to address this problem, and reviews maternal and fetal outcomes from a sizeable database of the most common cases of cancer in pregnancy. In reviewing this program and the experience of others in this area, this volume sets out to create a clinically relevant tool for oncologists, obstetrician-gynecologists, perinatologists and neonatologists.
Preface G. Koren, M. Lishner and D. Farine; Introduction; 1. Cancer in pregnancy:: Identification of unanswered questions on maternal and fetal risks G. Koren, L. Weiner, M. Lishner, D. Zemelickis and J Finnegan; 2. The pregnant patient with malignant disease - maternal fetal conflict D. Farine and E. N. Kelly; 3. Changes in drug disposition during pregnancy and its clinical implications G. Koren; 4. The role of the placenta in biotransformation of carcinogenic compounds L. Derewlany and G. Koren; 5. Antepartum fetal monotoring in the oncologic patient Y. Ezra and K. Panter; 6. The Toronto Study Group - Methodological Notes; 7. Motherisk - The process of counselling in reproductive toxicology G. Koren and A. Pastuszak; Specific Tumors During Pregnancy:: 8. Maternal and fetal outcome following breast cancer in pregnancy D. Zemlickis, M. Lishner, P. Degendorfer, T. Panzarella, B. Burke, S. B. Sutcliffe and G. Koren; 9. Maternal and fetal outcome following Hodgkins disease in pregnancy M. Lishner, D. Zemlickis, P. Degendorfer, T. Panzarella, S. B. Sutcliffe and G. Koren; 10. Non-Hodgkins lymphoma and pregnancy D. Zemlickis, M. Lishner, S. B. Sutcliffe and G. Koren; 11. Maternal and fetal outcome following invasive cervical cancer in pregnancy M. Lishner, D. Zemlickis, P. Degendorfer, T. Panzarella, S. B. Sutcliffe and G. Koren; 12. Pregnancy and ovarian cancer M. Lishner and G. Koren; 13. Malignant melanoma and pregnancy M. Ravid and M. Lishner; 14. Leukemia during pregnancy M. Lishner; Fetal Effects of Cancer and its Treatment:: 15. Prenatal irradiation and cancer Y. Bentur; 16. Review of fetal effects of cancer chemotherapeutic agents D. Zemlickis, M. Lishner and G. Koren; 17. Fetal outcome folowing in utero exposure to cancer chemotherapy - The Toronto study D. Zemlickis, M. Lishner, P. Degendorfer, T. Panzarella, S. B. Sutcliffe and G. Koren; 18. Intrauterine causes of tumors in later life G. Koren; 19. Fetal tumors P. McParland; Index.
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