January is Cervical Health Awareness Month. Learn how women with cervical cancer can manage potential fertility concerns.
A diagnosis of cervical cancer can bring about a wide range of emotions and questions. Because many of the treatments for cervical cancer can have a permanent impact on the reproductive system, people with this diagnosis often express concern about fertility and the ability to carry children after treatment has ended. For women who may want to have children in the future, it is important to learn about potential reproductive side effects of treatment, communicate your concerns with your medical team and seek emotional and practical support.
How Can Treatment for Cervical Cancer Impact Fertility?
Learning about potential treatment options can help you better advocate for yourself and make choices about any fertility preservation options that may be available to you. If you have questions about your specific treatment plan, speak to your medical team. They will be able to best provide answers based on your specific case.
Treatment for cervical cancer usually involves surgery, and may also include chemotherapy and/or radiation depending on the stage of the cancer and the size of the tumor. Surgery to treat cervical cancer may include a hysterectomy (the removal of the uterus and potentially other reproductive organs), after which a woman would not be able to become pregnant. For some women with earlier stage cervical cancer, a procedure called a radical trachelectomy may be an option: this surgery removes the cervix but leaves the uterus, potentially enabling a woman to have a pregnancy and deliver the baby via caesarean section.
If a fertility-sparing surgery is an option, it is important to note that chemotherapy and radiation may also impact the chances of becoming pregnant. Some chemotherapy drugs can damage the eggs within a woman’s ovaries, which can lead to reduced fertility or infertility. Additionally, chemotherapy can cause changes to a woman’s menstrual cycle, which may remain impacted even after chemotherapy has concluded. Radiation to the pelvis can often cause damage to the ovaries and uterus.
For these reasons, some women opt to explore egg or embryo freezing prior to beginning treatment, in the hopes of later utilizing their own eggs or embryos to carry a child themselves or via another woman who carries the pregnancy for them (called a gestational surrogate).
Managing the Practical and Emotional Effects of Fertility Concerns
Thinking about your future family-building wishes in the midst of a cancer diagnosis and treatment can understandably feel overwhelming. Without being able to know the exact impact that the treatment will have on your body, or how successful the fertility preservation procedures you may undergo will be, it may feel difficult to make decisions. The following suggestions may be helpful as you think about reproductive concerns following a cervical cancer diagnosis:
Making fertility-preservation decisions at a time when you are likely also coping with many challenging emotions and under a time-constraint can feel daunting. Know that there are not right or wrong answers about how to proceed, how you may elect to preserve your fertility, or how you may build your family in the future.
Stacy Chilton, LMSW, is the Women’s Cancers Program Coordinator at CancerCare. She oversees CancerCare’s Women’s Cancers Program, as well as provides counseling to people coping with cancer and people who have experienced the loss of a loved one.