Challenges in the Treatment of Oncological Diseases during Pregnancy

Introduction. The issue of diagnosing and treating oncological diseases during pregnancy remains highly relevant, as physiological changes may hinder early detection, while therapeutic decision-making is complicated by the need to minimize fetal risks and ensure effective treatment for the mother. This article discusses the specifics of treatment strategy selection, potential risks for both the mother and the fetus, and approaches to minimizing adverse outcomes. The aim of the study is to analyze treatment strategies for oncological diseases during pregnancy, compare treatment effectiveness, and assess the impact on fetal development. Materials and methods. An analysis of current literature was conducted, enabling the systematization of the structure of oncological diseases in pregnant women, treatment options, and potential outcomes. Additionally, a clinical case from the practice of the Republican Oncology Dispensary was examined, illustrating the real-world challenges and solutions in managing such patients. Results. Based on the conducted analysis, it has been established that the management of pregnancy in the context of oncological disease requires a careful balance between therapeutic efficacy and fetal safety. In particular, surgical intervention and chemotherapy are considered permissible after the first trimester, whereas radiotherapy, whenever possible, is postponed until the postpartum period. However, data on the long-term outcomes for the child remain inconclusive: some studies indicate an increased risk of preterm birth and mild cognitive impairments, while others do not reveal significant deviations. Discussion and conclusion. The results obtained confirm that the treatment of cancer during pregnancy requires an individualized approach that takes into account both the stage of the disease and the gestational age. The presented clinical case of a patient with advanced rectal cancer in the third trimester illustrates the feasibility of using XELOX chemotherapy (capecitabine, oxaliplatin) in combination with pregnancy-prolonging measures to improve perinatal outcomes. At the same time, the prognosis for the mother remains dependent on the biological characteristics of the tumor, underscoring the need for further research in this area.