Managing cancer during pregnancy: Experiences from a large cancer center in Texas.

369 Background: Cancer affects 1 in 1000 pregnancies annually, with breast, cervix, and melanoma being the most common. Managing cancer during pregnancy poses unique challenges, balancing oncologic and obstetric needs. This complexity is increased at cancer centers, which may not offer specialized obstetrical care. We developed the Pregnancy and Oncology Program (POP) to ensure safe, coordinated care for pregnant cancer patients. Methods: Launched in August 2022 at a large cancer center in Houston, Texas, POP provides comprehensive care coordination for pregnant cancer patients. A trained nurse liaison facilitates care between the patient’s oncology and obstetrical teams including standardized counseling, arranging specialized services, lactation consultation, and care delivery at the appropriate facility. If needed, this liaison facilitates a Maternal Fetal Medicine (MFM) referral at a nearby institution. For patients receiving chemotherapy or surgery, MFM counseling occurs with a pre-intervention multidisciplinary discussion to optimize care. This program also standardizes emergency readiness for these patients by developing multidisciplinary action plans for obstetric and oncologic emergencies. To assess the program, data was collected retrospectively and prospectively on demographics, cancer type and stage, treatment, and pregnancy data. Descriptive statistics were performed. Results: From August 2022 to May 2025, 134 pregnant cancer patients received care navigation through our program, including 65 MFM referrals, of which 45 individuals agreed to join our database. The average age was 33 years. Participants were 82.2% White, 6.7% Black, and 11.1% other race, with 17.8% identifying as Hispanic. Cancer types included: breast (42.2%), skin (26.7%), leukemia (8.9%), cervix (6.7%), colorectal (6.7%), thyroid (4.4%), and head & neck (4.4%). For staging, 44.2% were Stage I, 14.0% Stage II, 14.0% Stage III, 9.3% Stage IV, and 18.5% unknown. Patients received a combination of therapies, including systemic therapy (68.3%), surgery (46.7%), and post-partum radiation (11.7%). Treatment was delayed until after delivery for 3.3%. Gestational age at referral ranged from 6 to 34 weeks, as well as postpartum. Of the patients with delivery information recorded, 93.7% had live births and 6.3% had medically indicated terminations. The average gestational age at delivery was 35 weeks, with an average birthweight of 6.2 pounds. Conclusions: Caring for pregnant cancer patients presents unique challenges, particularly within cancer centers amid an increasingly complex sociopolitical landscape. By developing a comprehensive program with dedicated navigation and support services, patients receive coordinated care from both oncologists and MFM specialists, optimizing cancer treatment and obstetrical care that aligns with patients’ goals.