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  • Q&A with Australian Health Practitioners

    Is it safe for me to conceive after undergoing cervical cancer treatment?

    Related Topics
    Cancer Cervical Cancer Pregnancy & Breastfeeding
    • 2 answers
    • Prof Jonathan Carter
    • Dr Gary Sykes
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    Prof Jonathan Carter

    Gynaecological Oncologist

    Professor, Department of Obstetrics and Gynaecology, The University of Sydney Head Sydney Gynaecologic Oncology Group, Royal Prince Alfred Hospital Head Gynaecology Services, Sydney South West … View Profile

    Pregnancy is only possible in early cervical cancer treatment, if fertility sparing surgery has been undertaken, that is a cone biopsy or a radical trachelectomy. After a perio of surveillance, certainly pregnancy is achievable. A cone biopsy is undertaken when the cancer invades very superficially into the muscle of the cervix, usually less than 3mm; whereas a trachelectomy is a little bit more than that. You know from our experience that the risk of spread to lymph nodes is low and the risk of recurrence is very low and that's why we'll offer fertility sparing surgery in those situations. Any cervical cancers larger than that, really need to be treated by definitive surgery, and that is the radical hysterectomy and carrying an interuterine pregnancy is obviously not possible.

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    Dr Gary Sykes

    Obstetrician

    Dr Gary Sykes is a graduate Bachelor of Medicine and Bachelor of Surgery (M.B, B.S.) from Sydney University. He commenced his initial postgraduate training at … View Profile

    I agree with Prof Carter’s excellent reply.

    An extra comment is that I often get patients who say they have had cervical cancer when this has not been the case. Rather they have been treated for Cervical Intraepithelial Neoplasia (CIN or abnormal changes in the skin of the cervix that without treatment can lead to cancer in the future).

    CIN is not cancer and the situation is easily clarified by history taking at the initial pregnancy consultation.

    CIN is surgically treated by a day surgery operation. Over the years there have been various treatments with a currently popular procedure being a LLETZ procedure (Large Loop Excision of the Transformation Zone of Cervix).

    While the obstetrician needs to know this history so there can be appropriate monitoring of the cervix in pregnancy in case it has been shortened or weakened by the surgery, usually this is not the case and usually there is no problem in pregnancy. Occasionally there has been significant weakening or shortening of the cervix. If this has been the case a cervical suture needs to be inserted to prevent the cervix opening, usually during mid pregnancy, with loss of the baby as a consequence. This condition is called ‘cervical incompetence’.

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