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Treatment | Fertility-sparing surgery

 Is it possible to preserve my fertility after receiving a diagnosis of gynecologic cancer?

 See also: Ask the Pros: What are the risks of a Loop Electrosurgical Excision Procedure during pregnancy?

 

 Is it possible to preserve my fertility after receiving a diagnosis of gynecologic cancer?

 Gina, Pennsylvania, USA: With my initial diagnosis of early stage ovarian cancer, there was a very large tumor attached to my right ovary. Because I was 26 and hoped to preserve my fertility, my doctor and I agreed to surgically remove the tumor and ovary only.

Eighteen months later, I had a recurrence, and at that time, a couple of smaller tumors were removed, along with my right fallopian tube. Again, no chemo or radiation afterwards, just diligent follow-up with CT scans and blood work.

Over the next five years, I had four more cancer recurrences, and each time, my doctor and I talked it out and agreed together to continue with conservative surgical treatment, i.e. cutting out the tumors and minimal parts of organs to which they were attached. By this time, I was very frantic about preserving my fertility, and prior to each operation my doctor was always clear that a more aggressive approach (total hysterectomy along with removal of the remaining ovary) probably would prove to be a long-term solution. While I didn't want to take unnecessary risks, I always felt safe enough in my decision to have conservative surgery, as my desire to preserve fertility was a major issue for me.

In my final recurrence, the tumor was attached to my left ovary, and some cancer was present on two other organs as well, so there was really no choice except to have the total hysterectomy and remove the left ovary. If I had wanted to, I guess I could have chosen to have the left ovary removed and leave my uterus to pursue some kind of in vitro procedure, but by then, I was really scared to see the cancer had spread to other organs that previously hadn't been involved. My doctor brought up the possibility, but I didn't choose to pursue the conversation. Sad as I was to lose my fertility, I was ready to have the total hysterectomy/oophorectomy and feel "safe in my own body" once more (a feeling I hadn't had in a long, long time).

I know that it is NOT the usual course to treat stage 2 and 3 ovarian cancer with surgery ONLY, but in my case, it appeared to be an option. My fertility was a major, driving force in deciding the treatment of my disease. Throughout, I was very insistent, and did a lot of research to educate myself and I talked very openly with my doctor about it. I never insisted on anything that my doctor advised strongly against; I always felt I was choosing the conservative end of appropriate treatment, and was not putting myself at undue risk.

By the way, I just want to clarify, in case anyone is wondering, that while I didn't ultimately preserve my fertility, I did indeed become a parent through adoption to the two beautiful and precious children whom, I believe, God meant for me to have all along!

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