Cancer, also known as malignancy, is a condition in which the body’s cells develop abnormally. By continuing to develop, cancerous tumors have the ability to infiltrate healthy cells and spread to other parts of the body.

What exactly is cervical cancer?

Cervical cancer is a cancer that develops in the cervix. The lowest section of the uterus is attached to the vagina. Every woman is at risk of developing cervical cancer at some point in her life. According to statistics, over 13,000 people are diagnosed with cervical cancer each year. 

Cervical cancer is most often seen in the transition zone of the cervix. It may later spread to other organs such as the lungs, liver, and lymph nodes. Cervical cancer may impact female reproductive organs such as the ovaries and fallopian tubes, resulting in infertility in some.

What are the stages of Cervical cancer?

Stage I: Abnormal cells form in the cervix’s innermost lining. Cervical cancer that is invasive and only affects the cervix.

Stage II: Loco-regional spread of cancer beyond the uterus but not to the pelvic sidewall or the lower third of the vagina.

Stage III: It extends to the pelvic wall or the lower portion of the vagina, causing hydronephrosis or a non-functioning kidney as a result of ureter invasion.

Stage IV: Cancer has spread beyond the true pelvis or into the bladder or rectum mucosa.

How can Cervical Cancer Impact Fertility?

The most often asked question by cervical cancer sufferers is whether or not it impacts their fertility. Female fertility concerns are affected by a variety of factors, including the stage of cancer and the therapy suggested for them.

Treatments and medications for advanced cervical cancer may have an impact on fertility and the patient’s ability to have a child. Treatments such as radiation, chemotherapy, and surgery, for example, might affect the uterus and ovaries, resulting in infertility. 

Depending on the specific instance and kind of cancer, options such as oocyte cryopreservation or embryo freezing may be available. Treatments such as fertility-sparing procedures such as conization and simple or radical trachelectomy, which have a 70% likelihood of success, may also be considered. Trachelectomy is the recommended therapy for patients in the early stages of cervical cancer. Miscarriage or early delivery are risks associated with these surgical therapies. As a result, before beginning therapy, it is critical to explore these treatment alternatives and reproductive problems with a fertility specialist.

The most crucial measure someone can do is to have a preventative test, which may help diagnose cancer at an early stage when it is less aggressive and treatment is much milder. Early detection and treatment also help to restore fertility issues.

Early stages of cervical cancer

Cervical cancer in its early stages is usually asymptomatic, although it may be detected by preventative testing such as a Pap smear. It is preferable to diagnose cancer in its early stages, when it is curable. According to statistics, women who are diagnosed with cervical cancer and undergo early diagnosis have a 92% chance of surviving over a five-year period.

  • Abnormal vaginal bleeding between menstrual cycles, after intercourse, post-menopause, and other symptoms of advanced cervical cancer include: Cervical cancer is often indicated by abnormal vaginal discharge with a strong odour and blood.
  • Pelvic pain
  • Severe pain during or after sexual intercourse

These symptoms might be caused by a variety of factors, including infection. Anyone having these symptoms, however, should see a doctor and get a gynecological examination.

What effect does cancer therapy have on fertility?

Certain cancer therapies might have a negative impact on your fertility. The consequences might be either transient or permanent. The chance of cancer therapy affecting your fertility is determined by the kind and stage of cancer, the type of cancer treatment, and your age at the time of treatment. Cancer treatments and their consequences may include:

  • Surgery. The surgical removal of the testicles, uterus, or ovaries might affect fertility.
  • Chemotherapy. The effects are determined by the medicine and the dosage. The most damage is caused by drugs called alkylating agents and the drug cisplatin. Younger women who get chemotherapy are less likely than older women to become infertile.
  • Radiation. Depending on the location, size, and dose of the radiation field, radiation can be more detrimental to fertility than chemotherapy. High doses of radiation, for example, can damage some or all of the eggs in the ovaries.
  • Other cancer treatments. Hormone therapy used to treat some diseases, particularly breast cancer in women, can have an impact on fertility. However, the consequences are frequently reversible. Fertility may be recovered once therapy is completed.

How can women retain their fertility before undergoing cancer treatment?

When it comes to fertility preservation, women who are going to undergo cancer treatment have several alternatives. 

  • Embryo cryopreservation. This method entails collecting eggs, fertilizing them, and freezing them so that they can be implanted later. Embryos can survive the freezing and thawing procedure up to 90% of the time, according to research.
  • Freezing eggs (oocyte cryopreservation). Your unfertilized eggs will be collected and frozen during this procedure. Human eggs do not freeze as well as human embryos.
  • Radiation shielding. Small lead shields are put over the ovaries during this treatment to decrease the amount of radiation exposure they get.
  • Transposition of the ovaries (oophoropexy). The ovaries are surgically moved in the pelvis during this treatment so that they are not in the radiation field when radiation is supplied to the pelvic region. Ovaries, however, are not always protected due to scattering radiation. To conceive again after treatment, you may need to have your ovaries relocated.
  • Surgical removal of the cervix. To treat early-stage cervical cancer, a large cone-shaped section of the cervix, including the cancerous area, is removed (cervical conization). The remaining cervix and uterus are maintained. A surgeon can also partly or totally remove the cervix and the connective tissues around the uterus and cervix (radical trachelectomy).

How to Preserve Fertility with Cervical Cancer?

The best strategy may be to have a thorough discussion with your doctor about all of the potential choices for treating cervical cancer. According to fertility specialists, the less tissue removed from the cervix, the better. A woman may have a fair chance to get pregnant if the uterus and a large portion of the cervix remains and the ovaries have not been rendered sterile with therapy. Furthermore, early discovery of cervical cancer may need trachelectomy, a technique that allows a portion of the cervix to remain intact, therefore maintaining fertility and providing a possibility for conception.

If your therapy does not require the removal of the uterus, you can freeze your eggs. Conception is possible using in-vitro fertilisation, which uses frozen eggs and fresh or frozen sperms. Consider surrogacy if your uterus is removed. You might want to consider egg donation or having a child through surrogacy. If you’ve had radiation or other treatments that caused infertility, talk to your doctor about exploring alternative methods of conception.

What Are the Chances of a Healthy Pregnancy Following Cervical Cancer Treatment?

Yes, a woman can become pregnant after undergoing cervical cancer therapy. The possibility of a safe pregnancy following cervical cancer therapy is obviously a concern. However, ongoing research and various studies in this sector have yielded excellent findings, providing optimism. Other treatments, such as guarding the ovaries in radiation and collecting and extracting eggs before starting therapy, are being researched.

Furthermore, while treatments like a cone biopsy can increase the chance of miscarriage and early delivery, they have a relatively minor influence on a woman’s fertility. However, it is treatable with careful care and continuous monitoring of the pregnant lady throughout her pregnancy. Early cancer detection can significantly boost a woman’s chances of becoming pregnant. Before commencing therapy, it may be prudent to consult with your doctor about the best choices. Furthermore, you should not be concerned about the recurrence of cervical cancer during pregnancy because it is not oestrogen-dependent.

What if you are unable to conceive naturally as a result of your cervical cancer treatment?

Having surgery might make it difficult to conceive. It may also have an impact on prenatal tests, pregnancy, labor, and delivery. Reduced cervical mucous, cervical stenosis, early dilation, or an incompetent cervix are all potential complications. In such a scenario, intrauterine insemination (IUI) can be a feasible option to get pregnant. To transfer sperm directly into the uterus, your doctor may insert a small catheter through the cervix. If there is premature dilatation due to a weak cervix, a cerclage (a stitch) in the cervix can keep it closed. If you miscarry as a result of early dilation, your doctor may decide to place cerclage before you become pregnant, and you will most likely have a C-section.

In most situations, advances in scientific therapies have made it feasible for a woman to conceive after undergoing cervical cancer therapy. You may need to seek the assistance of a perinatologist, who will check your cervix from the start of your pregnancy. So, don’t give up hope and seek medical advice if needed.