Fertility Preservation Rates May Increase With Uterine Transposition in Pelvic Cancers

Historically, patients with uterine or colorectal cancer faced a challenging dilemma: the need to balance effective cancer treatment with the potential for radiation-induced infertility. While previous approaches focused on mobilizing the ovaries to minimize radiation exposure, uterine transposition introduces a more comprehensive strategy.

John Paul Diaz, MD, chief of gynecologic oncology, director of robotic surgery, director of the Center of Excellence in Minimally Invasive Gynecologic Surgery at Baptist Health, and lead physician for Clinical Trials in Gynecologic Oncology at Miami Cancer Institute in Miami, Florida, noted that by carefully relocating the entire uterus outside of the radiation field, this technique offers a unique opportunity to protect the uterus’s reproductive function. This is a groundbreaking development, as no existing radiation techniques can safely preserve uterine function while delivering effective cancer treatment.

According to Diaz, uterine transposition holds the potential to revolutionize the care of patients with pelvic cancers, providing them with a viable option to pursue both successful cancer treatment and the fulfillment of their family planning goals.

Transcript:

For some time, we’ve been looking at how can we treat these cancers for women and preserve their fertility. [There are] different things that we’ve tried in the past, but when [patients are] going to receive pelvic radiation, we would mobilize the ovaries out of the radiation field, and now at least try and preserve the ovaries so they can contain their estrogen production and possibly allow them for a genetic child in the future with a surrogate carrier.

We’ve also done other techniques, such as a radical trachelectomy described in the first series over 15 years ago. We continue to try and adapt our treatments for these young patients, where we can successfully treat their cancers but preserve fertility. The interesting part about this technique is we’re preserving the entire uterus. These patients can receive their pelvic radiation and then be able to carry a child in the future. There’s no radiation technique now that can safely be performed to preserve this uterus function. This is an exciting and big change in the treatment of [patients with] these cancers.