Research on young individuals and childbearingadults being treated for neoplasia has revealed a rising number of requests for treatmentsaimed to maintain the possibility to conceive. To answer such requests, it isimportant for medical professionals to consider the necessity to cure thewoman, to preserve her fertility, to give information both on the effect ofneoplasia and treatments on pregnancy. Patients have to be informedon the possible treatment alternatives that are less aggressive towards thereproductive function, but at the same time, give desirable results in terms ofsurvival. Neoplasiaand Fertility describes the state-of-the-arton fertility preservation in women affected by neoplasia. The 11 book chapters informthe reader with the goal of equipping them with the required information needed to present the condition and to discuss the possibility of conceiving, andhow to manage patients after oncologic treatments at different stages of pregnancy. KeyFeatures- Informs the reader about therelationship between gynecological cancer and fertility in women through 11 chapters- Describes a broad range of cancers andrelevant treatment options for maintaining fertility- Explains the role of a ‘FertilitySparing Team’ in clinics- Familiarizes the reader with theethics behind oncology treatments with reference to female fertility- Describes fertility issues related to hereditarycancers in women- Includes references for furtherreading The book serves as an informativereference on the subject to medical doctors in the gynecology, obstetrics and midwifespecialties, and nurses training the gynecological oncology. It will also be ofinterest to healthcare administrators involved in fertility and oncologyclinics, as well as general practitioners in family medicine."
Table of Contents
- Preface
- List of Contributors
- Surgery and Cervical Cancer in Pregnancy
- Lorenzo Ceppi, Tommaso Grassi, Robert Fruscio, Eleonora Preti and Fabio Landoni
- Cervical Cancer and Fertility Sparing Surgery
- Introduction
- Fertility-Sparing Surgery
- Figo Stage Ia
- Figo Stage Ib
- Clinical and Histological Characteristics Evaluation
- Choice of Fertility Sparing Surgery Technique
- Figo Stage Ib1 and Tumor Size < 2.0 Cm (2018 Figo Stage Ib1)
- Figo Stage Ib1 and Tumor Size > 2.0 Cm (2018 Figo Stage Ib2)
- Figo Stage Ib2 E Iia (2018 Figo Stage Ib3 or Iia)
- Sentinel Lymph Node (Sln)
- Fertility, Live Birth, Prematurity Outcomes
- Overall Fertility
- Live Birth and Prematurity
- Cervical Cancer During Pregnancy
- Epidemiology
- Diagnosis and Staging
- Pap Smear Management
- Diagnostic Procedures in Pregnant Patients
- Therapeutic Options
- Non-Invasive Disease
- Invasive Disease
- Treatment Timing
- Delivery Modalities
- Effects of Pregnancy on Cervico-Carcinoma
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Angiolo Gadducci and Roberta Tana
- Introduction
- Fertility-Sparing Therapy of Young Women With Endometrial Complex Atypical
- Hyperplasia or Endometrioid Carcinoma
- Pregnancy Outcome in Young Women With Endometrial Complex Atypical Hyperplasia Or
- Endometrioid Carcinoma Treated With Fertility-Sparing Therapy
- Conclusions
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Tiziano Maggino
- General Consderations
- Surgical Staging
- Managing a Suspected Adnexal Mass in Childbearing Age
- Fertility-Sparing Surgery: Oncologic Outcome
- Fertility Outcome
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- P. Zola, C. Macchi, G. Parpinel, B. Masturzo, M. Laudani, E. Potenza and M. Mitidieri
- Introduction
- Epidemiology
- Diagnosis
- Clinical Examination
- Imaging
- Cyto-Histological Diagnosis
- Biomarkers
- Staging
- Management
- Surgery
- Radiotherapy
- Chemotherapy
- Hormone Therapy
- Supportive Therapy
- Prenatal Care
- Prognosis
- Birth Control
- Pregnancy After Breast Cancer
- Conclusions
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Cesare Romagnolo
- Introduction
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Cesare Romagnolo
- Introduction
- Thyroid Disease in Pregnancy
- Thyroid Carcinoma
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Enrico Sartori, Franco E. Odicino, Federico Ferrari and Valentina Zizioli
- Introduction
- Objectives
- Principles
- Principles During Surgical Procedures
- Principles During Medical Treatment (Chemotherapy)
- Principles of Radiotherapy
- Final Consideration of Principles
- Members of Fertility-Sparing Team
- Medical Figures
- Non-Medical Figures
- Design of Fertility Preservation Consultation
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Patients
- E. Antonini ?? B. Engl
- Introduction
- Oocyte Cryopreservation
- Spermatozoa Cryopreservation
- Embryos Cryopreservation
- Ovarian Parenchymal Tissue
- Conclusions
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Monica Della Martina, Giulia Trombetta, Martina Venier ?? Angelo Cagnacci
- Introduction
- Ovarian Protection During Chemotherapy
- Breast Cancer
- Hematological Neoplasms
- Protection During Radiotherapy
- Ovarian Transposition
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Treatment
- Monica Della Martina, Martina Venier, Giulia Trombetta and Angelo Cagnacci
- Introduction
- Uterine Cancer
- Breast Cancer
- Ovarian Cancer
- Cervical Cancer
- Vulva/Vaginal Cancer
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Malignancies
- Lino Del Pup and Fedro a Peccatori
- Introduction
- Methods
- Fertility Counseling in Brca Patients: Informing the Possible
- Fertility Effects, Premature Menopause and Fertility Options
- Brca1/2 Mutation Carriers Seem to Be as Fertile as Non-Carriers
- Brca Carriers Could Have An Abnormal Response to Ovarian
- Stimulation, But the Jury is Still Out
- Brca1 Mutation Carriers Seem to Have a Lower Level of Markers
- Of Ovarian Reserve (Amh)
- Brca1/2 Mutation Carriers Could Have a Premature Menopause
- Breast Cancer Risk in Brca1 Mutation Carriers Decreases With
- Increasing Age at First Birth
- Among Brca2 Carriers, Increased Parity Might Be Associated With
- An Increase in Premenopausal Breast Cancer Risk
- Brca 1-2 Mutations Increase the Risk of Cancer Before Parenthood 195
- Chemotherapy Seems to Induce More Amenorrhea and Premature
- Menopause in Brca2 Carriers
- Brca1/2 Mutation Carriers With Endocrine Responsive Breast
- Cancers Have An Additional Reproductive Risk Due to Tamoxifen
- Administration
- Brca1/2 Mutation Carriers Are Candidates for Prophylactic
- Oophorectomy, Which Reduces the “Reproductive Window Of
- Opportunity”
- Systematic Fertility Preservation in Healthy Brca Carriers
- Should Be Discussed, But Questions Remain
- Specific Risks of Ovarian Stimulation Are Not Well Known, And
- Letrozole Could Be a Good Option
- Cryopreservation of the Ovarian Cortex is Not Safe in Brca
- Carriers
- In Vitro Oocyte Maturation Could Be Useful, But It is Still
- Experimental
- Prophylactic Fimbriectomy is Still Experimental But Promising In
- Reducing Ovarian Cancer Risk while Maintaining Ovarian
- Function
- Lynch Syndrome and Fertility Counseling: Promote Early
- Gestation, Hormonal Contraception, Surveillance And
- Prophylactic Hysterectomy After Parity
- Promote Early and Multiple Parity as It Reduces Endometrial And
- Ovarian Cancer Risk
- Offer Hormonal Contraception to Reduce Endometrial And
- Ovarian Cancer Risk Before, Between, After or as An Alternative
- To Pregnancies
- Levonorgestrel Ius Reduces Endometrial Cancer Risk, But The
- Effect on Ovarian Cancer Risk is Still Controversial
- Gynecological Surveillance May Lead to Earlier Detection Of
- Precancerous Lesions, But It Could Lead to Invasive Procedures
- Because of False-Positive Rates
- Discuss Prophylactic Hysterectomy After Completing
- Childbearing as the Only Consensus Recommendation For
- Reducing Endometrial Cancer
- Conclusions
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Subject Index
Contributors
- Cesare Romagnolo
- Tiziano Maggino
