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With rising occurrences and notable death rates, cervical cancer is still one of the most prevalent cancers afflicting women worldwide, especially in low- and middle-income nations. The fact that HPV infection predominately affects women in their reproductive years is concerning, as it presents a twin challenge: battling cancer while maintaining the possibility of becoming parents in the future. The demand for fertility-preserving treatment options has grown as more young women are getting diagnosed.
With specialist treatments like radical trachelectomy, conization, and fertility-friendly chemotherapy, today's advanced cervical cancer care gives hope. Fertility preservation techniques including freezing eggs or embryos are amongst the most suitable options. Our interdisciplinary approach at BMCHRC ensures that cervical cancer afflicted women get skilled, compassionate treatment that takes into account both their survival and their future as mothers.
Cancer that originates in the cervix's cells is known as cervical cancer. The lower, narrow end of the uterus, or womb, is called the cervix. The uterus and vagina (birth canal) are connected by the cervix. Typically, cervical cancer progresses gradually over time. Cervical cells undergo a process called dysplasia, in which aberrant cells start to show up in the cervical tissue, prior to cancer developing in the cervix. The aberrant cells may eventually develop into cancer cells and begin to proliferate and spread more into the cervix and adjacent regions if they are not eliminated or stopped from proliferating.
Women who have low-risk, early-stage cervical cancer (tumour size <2 cm) can get their cancer treated in a number of ways while maintaining their fertility. Options include trachelectomy, which removes the cervix but leaves the uterus intact, and conization, which removes a tiny portion of the cervix along with involves thorough examination of the lymph nodes in the surrounding area.
Trachelectomy can be done through the vagina, abdomen, or utilizing minimally invasive surgery, and it delivers cancer survival rates similar to those of a more thorough the elaborative procedure called radical hysterectomy. Among the various techniques, vaginal trachelectomy typically leads to better postpartum results.
| Treatment Option | What It Involves | When It's Used | Benefits |
| Conization | Excision of a small tumour or aberrant cells from a little cone-shaped portion of the cervix by surgery. | Early-stage cervical cancer (tumor ≤ 2 cm). | Keeps the uterus and fertility intact; has no effect on subsequent pregnancies. |
| Radical Trachelectomy | Surgical excision of the upper vagina, surrounding tissues, and cervix while leaving the uterus intact. It can be performed minimally invasively, vaginally, or abdominally. | Early-stage cervical cancer (tumor ≤ 2 cm) with low risk of spread. | Preserves women’s chance to continue carrying a pregnancy; cancer survival rates are high. |
| Pelvic Lymph Node Assessment | Determining if cancer has progressed to the lymph nodes, typically following procedures like conization or trachelectomy that preserve fertility. | Early-stage cancers to ensure safe fertility-preserving treatment. | Ensures that cancer has not spread and aids in the planning of safe treatment options. |
| Neoadjuvant Chemotherapy followed by Surgery | Prior to undergoing fertility-preserving surgery, chemotherapy is used to reduce the tumour size. | Tumor size between 2–4 cm. | Increases the likelihood that fertility-sparing surgery will be effective, even for bigger tumours. |
| Egg Freezing (Oocyte Cryopreservation) | Collecting and freezing a woman’s eggs for future use before cancer treatment begins. | Before treatments like chemotherapy or radiation that can affect fertility. | Preserves a woman's ability to have genetic children later. |
| Embryo Freezing | Fertilizing eggs with sperm to create embryos, then freezing them for future use. | Before starting cancer treatment. | High success rates for future pregnancies using IVF. |
| Ovarian Tissue Cryopreservation | Removing and freezing ovarian tissue to reimplant after cancer treatment. | When immediate cancer treatment is needed and egg retrieval isn’t possible. | Can restore natural fertility and hormone function later. |
| Ovarian Transposition (Oophoropexy) | Surgically moving the ovaries away from the radiation field to protect them from damage. | Before pelvic radiation treatment. | Helps preserve hormone production and sometimes natural fertility. |
| Surrogacy | Using a surrogate to carry a pregnancy using the woman’s frozen embryos or eggs. | If the uterus must be removed or cannot carry a pregnancy after treatment. | Allows women to have biological children even if they cannot carry a pregnancy themselves. |
The chances of successfully treating early-stage cervical cancer are usually favourable, but it's important to keep in mind it doesn't necessarily mean all the affected women will have similar disease progression and response to the treatment. The survival rates for individuals with early-stage cervical cancer who receive standard treatment are excellent, and about 95% of those with the earliest stages (stage IA) of the cancer are still alive five years after diagnosis. However, each person with cancer is distinct, and it is challenging to predict what an individual should expect in the future.
At five years following diagnosis, over 90% of patients with slightly bigger tumours (stage IB1, which denotes that the disease is limited to the cervix and is less than 2 cm in size) are still living a quality life. If the cancer has progressed to the lymph nodes, the likelihood that it may return or spread to other organs and become life-threatening may increase.
A woman who has been diagnosed with cervical cancer may experience a range of emotions, particularly if she is worried about her future ability to conceive. In the next weeks and months, the patient will probably have a lot of questions. Which course of treatment maintains fertility while having the highest likelihood of remission? Does cancer have a chance of coming back? To completely comprehend your diagnosis, treatment plan, and available alternatives for fertility preservation, talk to your cervical cancer specialist about all of your questions and concerns. Treatment options may include radiation, chemotherapy, surgery, or a mix of these. In many situations, you can also choose techniques that will help you safeguard your future capacity to conceive.
Explore fertility-preserving treatment options for cervical cancer. Get personalised advice from cervical cancer & fertility specialists at BMCHRC.
Q1: Is it possible for me to become pregnant after being diagnosed with cervical cancer?
A: In many instances, women who have cervical cancer of early stages are still able to conceive. Conization, trachelectomy, and assisted reproductive procedures are among the fertility-preserving therapy choices based on your health state and cancer stage.
Q2: What choices do I have for preserving my fertility if I require cancer treatment?
A: Ovarian tissue preservation, ovarian transposition to preserve ovarian function during radiotherapy, oocyte (egg) freezing, embryo freezing, and radical trachelectomy—the removal of the cervix while leaving the uterus intact—are among the options.
Q3: Does a hysterectomy have to be performed on all women with cervical cancer?
A: No. In low-risk, early-stage instances, less invasive procedures like conization or trachelectomy can remove the cancer while leaving the uterus intact, enabling a subsequent pregnancy.
