Postmenopausal women tend to have the most diagnosed cervical cancer. Nonetheless, premenopausal women who want to conceive can also be diagnosed. Many women these days delay conception. Unfortunately, this can lead to cervical cancer before getting pregnant. Many treatments result in permanent infertility. However, options exist for cervical cancer and pregnancy. Some women who wish to preserve their fertility can still get pregnant.
Cervical cancer and pregnancy
The standard treatments for cervical cancer, a hysterectomy (simple or radical) and pelvic radiation, result in permanent sterility. Select patients with early-stage cancer could qualify for fertility-sparing options. These include radical fertility-sparing trachelectomy. Furthermore, the cervix is removed but the uterus is spared.
Approximately one-third of patients with cervical cancer may meet the criteria for this procedure. Due to the rarity of this procedure, many referring physicians do not know this procedure can be an option.
Radical trachelectomy candidates
Those who desire future fertility possibilities qualify. Otherwise, doctors prefer more conventional methods. Surgery can be more complicated when compared to a standard hysterectomy. Furthermore, a patient might have to meet with another gynecological oncologist. Not all of these specialists can perform fertility-sparing trachelectomies.
At a patient’s initial consultation, providers would obtain important information. This is to assess if it is an appropriate option. Some of these criteria include:
- Tumor size
- Any spread of disease on imaging
- The type of cancer
- Others depending on the patient
How is the procedure performed?
Several surgical options exist with a trachelectomy. These include vaginal or abdominal, and robotic or minimally invasive. In addition, most surgeons use either an incision on the belly or multiple smaller incisions. They also perform the surgery in a minimally invasive fashion. The surgery requires very careful dissection due to the steps involved. Furthermore, this keeps the uterus viable while eliminating cervical cancer. The general steps include:
- The surgeon dissects the uterus while the blood supply remains intact.
- They separate the cervix from the uterus.
- A stitch known as the cerclage is placed around the uterus base to secure it for fertility.
- The surgeon reconstructs the uterus to the top of the vagina.
Can you get pregnant after cervical cancer?
Yes. Pregnancy rates are very encouraging after a trachelectomy with close to 70 percent of women achieving pregnancy afterward. Some patients may require some reproductive assistance. For instance, they might need intrauterine insemination or in vitro. It is important to involve a reproductive specialty physician in these cases to offer guidance along the way. Also, patients will need to deliver via cesarean section because of the permanent cerclage placed at the base of the uterus to prevent premature delivery.
Dr. Jessica Stine is a gynecologic oncologist who is trained to perform trachelectomies on young women. Schedule a consultation with Dr. Stine by calling her office at 813-530-4950.
Cervical cancer is a serious health risk. We know cervical cancer as the “silent killer” because many times patients experience no symptoms. Unfortunately, by the time people do see symptoms, the disease spreads to other places. This makes treatment more tricky. The American Cancer Society estimates that in 2017, doctors diagnosed over 12,000 new cases of cervical cancer in the United States alone. Also, over 4,000 women died of the disease. Worldwide, the numbers increase. All women are at risk, so we will walk you through the cervical cancer risk factors.
Cervical cancer was once a leading cause of cancer deaths in American women. Some hopeful cervical cancer statistics are that it now lies at spot 14th. Over the last 40 years, associated death rates dropped by more than 50 percent. Equally hopeful is the 91 percent five-year survival rate for patients diagnosed at an early stage. Lastly, as you’ll read later on, new research gives us even more reason to believe the situation will continue to improve.
Vaccines and early detection can help
Progress also tells us that we can help prevent the disease. We learned the primary cause of cervical cancer: the human papillomavirus (HPV). Vaccines such as Gardasil and Cervarix help guard against HPV and its related diseases. Women’s Care Florida offers these vaccinations at each of our practice sites. Girls ages nine and older can get these in three doses. Learn more about HPV immunizations here.
Annual well-woman exams are another important weapon in the fight against cervical cancer. Pap smear and HPV tests are highly effective means of detecting cervical cancer as early as possible. During the exam, your Women’s Care Florida physician will talk with you to determine which screening tests you’ll need based on the current cervical cancer screening guidelines.
Reducing cervical cancer risk factors
You should take several additional actions to help with cervical cancer prevention. If you smoke, it’s important you quit. The American Cancer Society states that women who smoke are about twice as likely as non-smokers to get cervical cancer. Smoking also weakens the immune system and lessens its ability to fight HPV. To keep your immune system in working order, be sure to stay at a healthy weight and eat plenty of fruits and vegetables.
Women can also minimize their exposure to HPV and other sexually transmitted diseases by limiting their number of sexual partners. Also, use condoms when having sex. And while oral contraceptives are an effective means of preventing pregnancy, long-term use of birth control pills can also increase your risk of getting cervical cancer.
One factor that actually lowers the risk
And this leads us to the latest reason to stay positive: a recent report in the journal Obstetrics & Gynecology suggests that women who use an intrauterine device (IUD) as a means of birth control may be 30 percent less likely to get cervical cancer than women who don’t. Researchers arrived at this potentially significant finding through a worldwide review of studies concerning thousands of women who use an IUD and observing their rates of cervical cancer.
Although there isn’t a clear understanding of why an IUD offers women additional protection against cervical cancer, further study may reveal an effective means of fighting this deadly disease. For now, IUDs are not recommended for this use, but Women’s Care Florida will keep a close eye on future developments. And we believe continued progress in the fight against cervical cancer is a good reason to keep thinking positively.
To discuss how you can best protect yourself against cervical cancer, schedule your well-woman exam with a Women’s Care Florida physician.