Lavanya (name changed), in her early 30s, recently came in for a routine health check-up. When her HPV DNA test came back positive, further evaluation (including colposcopy, LEEP, and MRI pelvis) was recommended. She was subsequently diagnosed with early-stage cervical cancer (Stage-1 A1). As she prepared for treatment, her primary concern was whether it would affect her chances of conceiving in the future and whether her fertility could be preserved.
When detected early, cervical cancer is potentially curable, and fertility-preserving procedures have a higher chance of success. Routine screenings and HPV vaccinations are essential for the early identification and prevention of cervical cancer. Women who prioritize regular health check-ups and stay informed about medical advancements can face these challenges and ultimately triumph over cancer. In Lavanya's case, a robotic-assisted radical trachelectomy with sentinel node dissection ensured her fertility was preserved, and no additional treatment was necessary. Today, she is recovering well and continues to follow up with her healthcare team.
Cervical cancer poses significant health risks to women. While vaginal bleeding, pelvic pain, and unusual vaginal discharge can be symptoms of cervical cancer, it is often asymptomatic in its early stages. By the time it is detected, the tumors may have spread to nearby reproductive organs, impairing fertility. Therefore, early detection is crucial for patients desiring to have children.
Cervical cancer and its therapies can significantly impact a woman’s fertility, depending on the disease stage and type of treatment needed. For example:
Surgeries like radical hysterectomy, which involves removing the uterus and cervix, completely eliminate the possibility of conception.
Radiotherapy can harm the ovaries, causing early ovarian failure or infertility.
Chemotherapy can also affect ovarian function, though it is generally less damaging than radiation therapy.
However, minimally invasive procedures supported by endoscopic methods have created new opportunities for fertility preservation. These techniques allow for the precise removal of tumors while preserving the uterus and ovaries, enabling the possibility of future fertility. Endoscopy also reduces healing time and minimizes disruption to reproductive organs, offering women renewed hope of becoming mothers after treatment.
Additionally, fluorescence-guided surgery (FGS) is enhancing the precision and safety of minimally invasive fertility-sparing treatments. By using near-infrared fluorescence imaging technology, surgeons can accurately visualize blood flow, lymphatic drainage, and tumor margins, which allows them to remove cancerous tissue with minimal damage to surrounding healthy structures.
For women diagnosed with early-stage cervical cancer, fertility-sparing treatments like trachelectomy (removal of the cervix while preserving the uterus) may be a viable option. Patients undergoing chemotherapy or radiation therapy can also choose to freeze their eggs or embryos before starting treatment. These frozen eggs or embryos can be used for assisted reproduction through IVF when needed.
By staying informed and exploring fertility-preserving options, women like Lavanya can face cervical cancer with the hope of preserving their fertility and fulfilling their dreams of motherhood in the future.
Dr.Rohit Raghunath Ranade
consultant gynaecological oncologist, Narayana Health, Bengaluru