Good news!
When a woman hears the dreaded words, “You have cancer,” haunting images of a hysterectomy, chemotherapy, and radiation treatment come to mind. For women who have not yet had children or desire more children, the possibility of a hysterectomy is devastating. According to a recent study by the Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine (Seoul, Korea), some women with early cancer can be treated conservatively and maintain their child-bearing ability. The researchers analyzed the medical records of 35 women with early-stage endometrial adenocarcinoma (cancer of the uterine lining) who were treated with the female hormone, progesterone, from January 1996 to December 2006. All women were treated with medroxyprogesterone acetate or megestrol acetate. Complete remission was defined as no evidence of endometrial adenocarcinoma or hyperplasia (thickening). Partial remission was diagnosed when the patient developed endometrial hyperplasia, and persistent disease was defined as the presence of residual adenocarcinoma. The median (average) patent age was 31 years (range: 21-43 years); the median follow-up period was 39 months (range: 5-108 months). For 22 patients, complete remission was achieved (62.9%), partial remission was achieved in one patient (2.9%), and 12 patients (34.3%) had persistent disease. The median time for a complete remission was nine months (range, 2-12 months). Of the 22 patients with a complete remission, nine (40.9%) had recurrent disease; the median time for a recurrence was 12 months (range, 8-48 months). Ten (83.3%) of the 12 patients with a complete remission who tried to conceive were able to achieve a pregnancy; eight of these 10 pregnancies resulted in live births. No congenital abnormalities were noted in the infants. The authors concluded that conservative treatment with progesterone should be considered as an option for a woman with early-stage endometrial adenocarcinoma who wishes to preserve her uterus or become pregnant.
Judging from the results of this study, a women who receives conservative treatment for endometrial cancer may ultimately undergo a hysterectomy; however, in many cases, this surgery can be postponed until after child-bearing is completed.
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