Can I have children after cervical cancer?
If you have early-stage cervical cancer, it might be possible to have a procedure that doesn't involve removing your womb.
While cervical cancer is among the top five female cancers in the world, the good news is that it often can be treated if it is caught early.
“Thanks to Pap smears, abnormalities in the cervix are picked up and treated before they progress to cancer,” says Dr Frances Paterson, an obstetrician gynaecologist and specialist urogynaecologist at Park Lane Clinic, Johannesburg.
If you have been diagnosed with early-stage cervical cancer, it may be possible to have surgery to remove the cancer without taking your womb out so that you still have a chance of becoming pregnant in the future says Cancer Research UK.
However, if you have advanced cervical cancer, you may need more aggressive treatment such as a hysterectomy where your womb and cervix are removed. This depends on how far the cancer has spread. Unfortunately, in this case pregnancy isn’t possible.
Treatment options
The Cancer Association of South Africa (CANSA) reiterates that cervical cancer treatment depends on:
- The stage of the cancer
- The size and shape of the tumour
- Your age and general health
- Your desire to have children in the future.
Should you want to have children, there are a few ways to preserve your fertility:
Freezing eggs or embryos
If you need to have chemotherapy or radiation, you may want to consider freezing your eggs before you get those treatments. As a member of the international Oncofertility Consortium, Johannesburg-based fertility clinic, Vitalab offers a specialised program for patients with cancer to preserve fertility before any treatment starts.
For instance, one of their procedures is Ovarian Transposition Surgery, which involves moving or suspending the ovaries to minimise the amount of exposure to radiation. There’s also the option to freeze your eggs or a fertilised embryo should you wish to conceive at least six months after chemotherapy or radiation.
LLETZ or LEEP procedure
This is a less invasive procedure where a large wire loop heated by an electric current is used to remove the abnormal tissue from your cervix.
The tissue is then sent to the lab to ensure that all the abnormal cells have been removed. Your doctor may well place a stich called a cerclage in your cervix after that too. The lab result of the tissue will determine whether the cancer/pre-cancer has been removed completely or not, says Gynaecologist and Obstetrician, Dr Mark van der Griendt.
“This surgery generally doesn’t cause issues with pregnancy but can in rare cases can cause the same issues as a cone biopsy,” says Dr Paterson.
According to CANSA, a cone biopsy involves removing a cone-shaped piece of tissue from the cervix and cervical canal. The overall size of the tissue removed will vary depending on the severity of the cancer.
“We generally don’t do cone biopsy’s for patients who still want to have children as it can cause stenosis (closure from scarring) of the cervix, depending on the amount of tissue removed, as well as possible incompetence of the cervix, where the cervix basically can’t stay closed during pregnancy,” explains Dr Paterson.
Radical trachelectomy
If you have a cervical malignancy and need to preserve your fertility, oncologists can perform a radical trachelectomy, which according to Cancer Research UK is a procedure where the surgeon removes most of your cervix and upper part of your vagina.
They then put a permanent stitch around the internal opening of the cervix to hold it closed. Research shows that babies have been born safely to women who have had this type of operation, but as Dr Paterson explains, a radical trachelectomy isn’t that common in South Africa as routine Pap smears generally pick up abnormalities before they progress to cancer, which means that treatment options such as a LLETZ are used instead.
Navigating all the emotions that often come with a cancer diagnosis, and its effects on fertility is an ongoing process. For further support and guidance, call CANSA’s toll-free line: 0800 22 6622 or find a CANSA Care Centre by clicking here.
IMAGE CREDIT: 123rf.com