I am used to facing dilemmas in my practice. But the most perplexing case I had was with a 35 yr old female who was at the same time 6 month old pregnant stage 4 with an oozing wound on the breast. What do you do? You end the pregnancy and do radiotherapy or chemotherapy? Or you go ahead do the modalities without batting an eyelash on the baby in uteru. Prolifers would squirm with this idea. In terms of treatment it is out of the question. A stage 4 breast cancer with metastasis all over the body has a few months to live. But we have to provide pain relief. Drugs like oxycontine and morphine will provide relief. But these are very toxic to the baby causing a lot of damage . I presented this case to the GYNECOLOGISTS and they opted for caesarean section to bring out the baby and give him a chance to live. As of me, I cannot do anything for the breast cancer. Surgery is out of the question because breast cancers are noted to bleed profusely even without stopping. The patient went into pulmonary edema and died before any intervention could be done. The baby died in uteru because the patient and relatives would not agree to any caesarean section.
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