The continuing evolution in surgical oncology is making it possible for more women to achieve fertility preservation – and proceed with plans to have children after cancer treatment. Gynecological Cancer Awareness Month is observed in September to raise awareness of cancers that affect the female reproductive system. These cancers include cervical, ovarian, uterine, vaginal, and vulvar cancer.
One such pivotal advance in fertility preservation involves uterine transposition, which preserves the patient’s fertility by sparing the uterus from radiation exposure.
John P. Diaz, M.D., Chief of Gynecologic Oncology at Baptist Health Miami Cancer Institute.
“Certain cancers, though treatable, have required women to forego their dreams of having children,” explains John P. Diaz, M.D., chief of gynecologic oncology at Baptist Health Miami Cancer Institute. “Naturally, the radiation treatment for the pelvis, which can save their lives, can also damage tissue of the uterus and make it difficult to bear children. But, now there's a surgical technique called uterine transposition. This surgery allows women who have been diagnosed with cancers in the pelvis and will require radiation treatment to preserve their ability to have their own biological children.”
Dr. Diaz was joined by Jean-Marie Stephan, M.D., gynecologic surgical oncologist at Baptist Health Miami Cancer Institute, for a new Doc-to-Doc podcast on uterine transposition.
Uterine transposition is a valid option for some women who require pelvic radiotherapy as cancer treatment, but are seeking to preserve fertility.
Explains Dr. Stephan: “Uterine transposition is a procedure where we're able to detach the uterus from its attachment to the vagina and its anatomical location in the pelvis, and lift it up to the upper abdomen where we will reattach it to the abdominal wall. Therefore, we are lifting it outside the radiation field, allowing the patient who's going require radiation to the pelvis to receive radiation without the uterus and the ovaries being exposed to that radiation.”
Jean-Marie Stephan, M.D., gynecologic surgical oncologist at Baptist Health Miami Cancer Institute.
Both Drs. Diaz and Stephan agree that advancements such as uterine transposition don’t just focus on cancer care and outcome but on quality of life post-cancer -- especially for patients who are young women hoping to have children. “Our patients have challenged us to think about life after cancer and how we can allow them to have a good quality of life, specifically when it pertains to uterine transposition,” said Dr. Diaz.
Who's a good candidate for uterine transposition?
“Any young woman who has cancer in the pelvis, and that could include cervical cancer, vaginal cancer, and rectal cancer,” said Dr. Stephan. “The first patient that underwent this procedure at Miami Cancer Institute was a rectal cancer patient. So, a young woman with cancer whose treatment is going to include radiation therapy to the pelvis is a good candidate.”
While Uterine transposition can be utilized in many cases of gynecologic cancers, the majority of the women who have undergone the procedure were being treated for colorectal cancers.
Adds Dr. Diaz: “In the past few years, there's been an increase in young women being diagnosed with colorectal and gynecologic cancers. The advent of these new technique is allowing them to pursue their starting of a family or continuing their family after successful completion of their cancer treatments.”
