Cancer during Pregnancy and treatment centres in NSW
Being diagnosed with cancer during pregnancy can be a challenging experience for the individual, their families, carers, and clinicians. As cancer diagnosed during pregnancy is rare, it is important people are referred into centres that have multidisciplinary teams, fetal maternal specialists and access evidence-based best practice care[1,2].
The Cancer Institute NSW has identified centres in NSW where cancer during pregnancy is able to be managed. Management within a coordinated multidisciplinary team which includes a maternal-fetal medicine specialist, neonatologist, midwife, pharmacist, reproductive medicine specialist, MotherSafe, dietician, social worker, specialist nurses, and the oncology team.
Based on recommendations by the European Society for Medical Oncology (ESMO)1, the following criteria were used to identify specialist centres for managing cancer in pregnancy:
- Department of Maternal-Fetal Medicine with accredited maternal-fetal medicine subspecialists onsite or networked.
- A cancer service onsite or networked (haematology/medical oncology/radiation oncology).
Actions for health professionals
Patient referral
People with a suspected or confirmed cancer during pregnancy should be referred to a specialist who is a member of a multidisciplinary cancer care team and practices at one of the centres listed below.
Involvement of a multidisciplinary team early in the cancer journey is recommended to ensure optimal assessment, care, and outcomes.
The Canrefer website allows you to find cancer specialists who are multidisciplinary team members, and has information about cancer services, optimal care pathways, and patient resources.
Smoking cessation support
Evidence suggests that tobacco cessation following cancer diagnosis improves survival. It also reduces treatment-related complications.[3, 4] Health professionals should discuss tobacco use with all patients and provide appropriate cessation support.
List of NSW Maternal Fetal Medicine units
| Local Health District | Hospital/s |
|---|---|
| Hunter New England | Calvary Mater Hospital and John Hunter Hospital |
| Nepean Blue Mountains | Nepean Hospital |
| Northern Sydney | Royal North Shore Hospital |
| South Eastern Sydney | Royal Hospital for Women and Prince of Wales Hospital |
| South Western Sydney | Liverpool Hospital |
| Sydney | Chris O’Brien Lifehouse Hospital and Royal Prince Alfred Hospital |
| Western Sydney | Westmead Hospital |
- If you are outside of the above local health districts you should access the tiered maternity network - maternal fetal medicine unit for your local health district.
- Women may need to be referred outside of their local health district to access specialist services.
References
- Peccatori FA, Azim HA Jr, Orecchia R, Hoekstra HJ, Pavlidis N, Kesic V, Pentheroudakis G; ESMO Guidelines Working Group. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Oct;24 Suppl 6:vi160–to70. doi: 10.1093/annonc/mdt199. Epub 2013 Jun 27. PMID: 23813932.
- Wolters V, Heimovaara J, Maggen C, et al Management of pregnancy in women with cancer International Journal of Gynecologic Cancer 2021;31:314–to322.
- Karam-Hage M, et al. Tobacco use and cessation for cancer survivors: an overview for clinicians. CA Cancer J Clin. 2014. 64(4):272–to90.
- Warren GW, et al. The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support. Lancet Oncol. 2014. 15(12):e568–to80.