Treatment preserves fertility after uterine cancer

Treatments for cancer of the endometrium, or lining of the uterus, often prevent future pregnancy, but new research shows that a limited form of treatment can destroy the cancer and still preserve fertility.

The therapy involves treatment with the hormone medroxyprogesterone combined with repeated scraping, or curettage, of the endometrium. However, for this conservative therapy to be considered, the cancer must be at an early stage. Moreover, the cancer often returns after treatment, so women need to be followed very closely.

For their study, Dr. K. Niwa and colleagues, from Gifu University School of Medicine in Japan, recruited 12 young women with early-stage endometrial cancer who wanted to retain their ability to become pregnant. They report their findings in BJOG: an International Journal of Obstetrics and Gynaecology.

Treatment sessions were every 4 weeks for 6 to 10 months, until all evidence of cancer was absent for at least 2 months. All 12 tumors had a complete response to treatment.

Of 10 patients attempting to become pregnant, 7 conceived, resulting in 5 single births, one set of twins, and one miscarriage.

Of nine women followed for several years, cancer returned in eight, with four women opting for hysterectomy and three undergoing repeat conservative therapy. One woman with three bouts of cancer eventually conceived and delivered a full-term baby.

None of the women had their cancer spread throughout the body and none died from their cancer.

SOURCE: BJOG, March 2005.