PREGNANCY AND GASTRIC CANCER. CASE REPORT AND LITERATURE REVIEW

Abstract

Stomach cancer during pregnancy is rare and is most often diagnosed in the late stages. Due to clinical symptoms, it is difficult to suspect and diagnose stomach cancer during pregnancy, as the discomfort caused by stomach cancer can be considered physiological. Due to the limitations of diagnostic tests related to fetal safety, delayed diagnosis, postponed treatment, hormonal and biological changes, immunosuppresion during pregnancy, advanced or metastatic stomach cancer is most commonly diagnosed (92–93%). The diagnosis in a pregnant woman poses a risk to the fetus not only due to neoplastic invasion but also due to the possibility of preterm delivery. When stomach cancer is diagnosed during pregnancy, the treatment method is chosen depending on the gestational age, the stage of cancer, the risk to the fetus, and the mother’s decision. It is better to start treatment after completing the pregnancy. Gastrectomy during a cesarean section is not recommended due to the high risk of hemorrhages and thromboembolism. Chemotherapy treatment is controversial due to its teratogenic effects, spontaneous miscarriage, and fetal death risks. The latest methods of stomach cancer treatment are based on immune and targeted therapies. This article discusses the clinical case of a 29-year-old patient who was diagnosed with stage IV stomach cancer with metastases to the ovaries and bones at 36 weeks of pregnancy, reviewing the possibilities of cancer diagnosis and treatment during and after pregnancy. This article discusses the clinical case of a 29-year-old patient who was diagnosed with stage IV stomach cancer with metastases to the ovaries and bones at 36 weeks of pregnancy, reviewing the possibilities of cancer diagnosis and treatment during and after pregnancy.