Perinatal cancer, though rare, accounted for 206 delivery cases in Virginia between 2020 and 2024, with breast cancer (16%) and lymphoma (12.6%) being the most frequently identified types.  The report highlights that while cancer during pregnancy presents diagnostic and treatment challenges due to overlapping symptoms and physiological changes, many cancers can be safely treated during pregnancy. Continued research, early detection, and multidisciplinary care are essential to improving outcomes and guiding clinical decisions for these complex cases.