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[Pregnancy, hormone preparations and malignant melanoma]
1Universitäts-Hautklinik und Poliklinik, Klinikum Steglitz, Freien Universität Berlin.
For decades pregnancy has been regarded as an unfavourable prognostic factor in women with malignant melanoma and for many patients termination of pregnancy was recommended. Likewise, it was suspected that pregnancy during the first few years after diagnosis of the tumor would impair the prognosis and, therefore, a contraindication was established. An analysis of the data of the Central Malignant Melanoma Registry of the German Dermatological Society revealed that 1% of female melanoma patients were pregnant and 40.5% were found to be in premenopausal status. In several recent studies survival rates of melanoma patients who were pregnant and those who became pregnant after diagnosis were compared to the rates in women without pregnancies. No significant differences were found. In addition, the use of oral contraceptives and menopausal estrogens, which were formerly thought to be related to an elevated risk of developing melanoma, was shown not to affect the risk and natural course of malignant melanoma. In conclusion, the recent results of extensive investigations no longer substantiate recommendations for abortion in pregnant melanoma patients. The use of oral contraceptives and menopausal estrogens is likewise no longer contraindicated in melanoma patients. A waiting period before having children may be recommended in the first 2-3 years after diagnosis, as this is the period with the highest probability of relapse, and one can be more certain that the course will be favourable.
For decades pregnancy has been regarded as an unfavourable prognostic factor in women with malignant melanoma and for many patients termination of pregnancy was recommended. Likewise, it was suspected that pregnancy during the first few years after diagnosis of the tumor would impair the prognosis and, therefore, a contraindication was established. An analysis of the data of the Central Malignant Melanoma Registry of the German Dermatological Society revealed that 1% of female melanoma patients were pregnant and 40.5% were found to be in premenopausal status. In several recent studies survival rates of melanoma patients who were pregnant and those who became pregnant after diagnosis were compared to the rates in women without pregnancies. No significant differences were found. In addition, the use of oral contraceptives and menopausal estrogens, which were formerly thought to be related to an elevated risk of developing melanoma, was shown not to affect the risk and natural course of malignant melanoma. In conclusion, the recent results of extensive investigations no longer substantiate recommendations for abortion in pregnant melanoma patients. The use of oral contraceptives and menopausal estrogens is likewise no longer contraindicated in melanoma patients. A waiting period before having children may be recommended in the first 2-3 years after diagnosis, as this is the period with the highest probability of relapse, and one can be more certain that the course will be favourable.