Surgical treatment of a gastric cancer in a pregnant woman without performing abortion

Abstract

Gastric cancer during pregnancy is extremely rare and there are problems in its diagnosis and treatment due to the presence of fetus. Beside the difficulties in diagnosis owing to the common symptoms of pregnancy, there are different practices during treatment procedure. Major concern in these cases is the situation of the fetus. There are different views on whether terminate the pregnancy or keep it until the term. It is undisputable that there must be not only medical but also ethical, social, cultural and religious considerations during decision making process. In this report, we planned to present our treatment process, medical outcomes, ethical issues and family involvement in a 23 weeks pregnant woman with gastric cancer. We performed total gastrectomy to the patient before the termination of pregnancy. There was no problem either in the mother or in the fetus at post-op stage. After 3 months, the patient gave birth to a healthy child in term. There was no recurrence or metastasis in post-op 9th month control. This information suggests us to be more sensitive on trying to keep fetuses alive until the term and re-evaluate our 'reflexive' attitude on terminating the pregnancy. Furthermore, we believe that terminating the pregnancy may -and will- cause biological and psychological trauma on mother which may -and will- affect the prognosis negatively.