More and more young women are affected by cancer of the reproductive organs and have not yet had a baby. Does cancer rule out any chance of motherhood? The 'I'm with you' programme was created to answer some of the most difficult questions people with genital cancer ask. We asked an expert in the field of gynaecological oncology - Professor Mariusz Bidzinski, MD, PhD - how to treat cancer in order to preserve fertility, what impact chemotherapy has on fertility and what are the chances of getting pregnant after such treatment.
Professor, does a diagnosis of "cancer of the genital organs" have to be immediately associated with infertility?
Not necessarily. If we diagnose cancer today, be it cervical cancer or ovarian cancer, the smaller the cancer focus, the easier the treatment with preservation of the reproductive organ. We have a whole group of patients who, with invasive cervical cancer, i.e. cancer which until recently was treated very radically and involved removal of the reproductive organs together with the lymph nodes, can now be treated in such a way that the reproductive organs are preserved.
But in order to use treatment to prevent infertility, an appropriate range of treatment measures must be in place to ensure that the patient's safety is high. Because in addition to qualifying the patient
for such a treatment, her safety is important. We cannot do something less if it is going to cause more problems.
So there are genital-sparing oncological operations to protect against infertility?
Yes, depending on the stage, it is possible to do a less radical operation, giving the opportunity for the treatment to proceed without too much trouble, while at the same time guaranteeing that we do not reduce the chance of a cure. In the case of invasive cervical cancer, where the cancerous lesions are up to 2 cm in diameter, trachelectomy can be used.
This is a procedure that involves removing the cervix with fragments of cervical tissue and with lymph nodes located in the pelvis, but leaving the uterine body, ovaries and fallopian tubes. This guarantees that the patient can have children in the future.
Is this method widely used?
Yes, there are already more than 500 babies in the world born after such a procedure. So it is no longer an experiment, but a method that has been registered in medical procedures. The same is true after treatment for ovarian cancer. There are also women who give birth to children. A very important thing in the case of fertility-preserving treatments is the correct qualification of the patient for the appropriate treatment. A great many points need to be checked in order to be able to say: 'this case can be treated with this method, and this case unfortunately already falls outside the standards of safe treatment'.
Because sometimes the use of such a method can be a factor accelerating some negative events. Here, it is very important to properly establish what the stage of the disease is and what the rules are in this respect. If a person meets these criteria, then sparing treatment can be offered. Certainly, a group of patients can benefit from such treatment.
