Background/Rationale:
Cancer during pregnancy is rare and complex, especially in recurrent or metastatic cases. This presentation explores the psychological, emotional, and ethical challenges faced by patients, families, and healthcare teams. Such cases often disrupt standard treatment, particularly when patients refuse curative therapies. The goal is to deepen understanding of the complex decision-making and emotional burdens involved. A clinical case will illustrate these challenges and how the multidisciplinary team addressed them.
Methods:
This presentation is informed by a narrative literature review and clinical experience. Key words used in the literature search included: cancer, pregnancy, psychological impact, metastatic cancer. The clinical case discussed is from a large tertiary referral centre, within a comprehensive cancer and obstetric service.
Impact on Practice:
Managing cancer in pregnancy requires balancing maternal health needs against foetal wellbeing, often presenting competing priorities. The multidisciplinary team (MDT) must navigate these sensitively, fostering informed and autonomous patient decisions grounded in personal values. Clear, compassionate communication tailored to the patient’s health literacy and psychosocial context is essential. Ethical considerations deeply influence both patient experience and clinician emotional wellbeing. Treatment decisions, including timing of delivery and therapy, significantly affect foetal development—neuropsychological outcomes and mother-child attachment are key concerns.
Discussion:
There are no current formal guidelines or treatment pathways on managing cancer in pregnancy. A diagnosis of cancer in pregnancy requires tertiary facility resources and support. This presentation highlights the critical role of psychosocial care, communication, and ethical reflection in these complex cases. Clinicians must be attuned not only to the patient’s psychosocial context but also to their own values and biases, ensuring that care remains patient-centred, empathetic, and ethically sound.