Management of Melanoma During Pregnancy

Sancy A. Leachman, MD, PhD; Ryan Jackson, HBS; Mark J. Eliason, MD; April A. Larson, MD; Jean L. Bolognia, MD

Disclosures

Dermatology Nursing. 2007;19(2):145-152,161. 

In This Article

Abstract and Introduction

There is no conclusive evidence that pregnancy adversely affects overall survival in patients with melanoma. Clinicians caring for pregnant patients should be as suspicious of changes in melanocytic nevi in these patients as they are for nonpregnant patients. Treatment of early-stage melanoma is the same irrespective of whether or not the patient is pregnant. Chemotherapeutic regimens for metastatic disease administered during pregnancy have not demonstrated significant efficacy.

The occurrence of malignancy during pregnancy complicates treatment and may affect outcome. Health care providers are challenged to maximally treat the mother while simultaneously protecting the fetus from harmful effects of the treatment (Jacobs, Chang, & Salti, 2004; Oduncu, Kimmig, Hepp, & Emmerich, 2003). Historically, there has been great concern and debate over the effect that pregnancy has on melanoma development and progression, as well as how that interaction influences patient management. Early beliefs about the behavior of melanoma during pregnancy were influenced strongly by a limited number of case reports and small case series. Larger, controlled studies are now available to guide decision making and management of this subpopulation of patients with melanoma. In this review we utilize our current understanding of how pregnancy may affect the patient with melanoma to provide suggestions for management. We begin with a review of the relevant literature on melanoma and pregnancy: how pregnancy affects melanoma predisposition, prognosis, and survival in addition to the impact of melanoma on the fetus. We conclude with a discussion of management of the pregnant melanoma patient with an emphasis on special concerns and considerations during pregnancy.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....