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Abstract

Cancer during pregnancy represents an increasing clinical challenge, largely due to rising maternal age. Diagnosis is hindered by the symptom overlap with the physiological changes of pregnancy and by limitations in diagnostic tests, some of which are contraindicated because of foetal risks. In this context, less invasive methods, such as ultrasonography and non-contrast magnetic resonance imaging, are recommended as first-line investigations. Regarding treatment, surgery is generally considered a safe option, whereas chemotherapy should be avoided during the first trimester. Radiotherapy, hormone therapy, targeted therapies, and immunotherapy are largely contraindicated. Prognosis is comparable to that of non-pregnant patients, provided that treatment is not delayed. Among the main challenges are complex ethical issues, limited robust evidence and a considerable psychosocial impact. This article aims to summarize best-practice principles for the management of cancer during pregnancy, based on international guidelines and specialized ethics literature, offering a practical guide applicable to the national context.