Treatment for Young Women with Early Stage Endometrial Cancer and Precancerous Conditions

MISS PATRICIA ELLIS, Consultant Gynaecological Oncologist & Surgeon RSCH

MISS PATRICIA ELLIS, Consultant Gynaecological Oncologist & Surgeon RSCH

Miss Ellis wanted to share the treatment she offers to young women with early stage cancers or precancerous conditions – Complex Atypical Hyperplasia (CAH) to help them to preserve their fertility prior to definitive treatment.

The standard surgical treatment for endometrial cancer is a hysterectomy and Bilateral Salpingo Oophorectomy (BSO) which is the removal of uterus, tubes and ovaries. However, young women with endometrial cancer may still wish to retain their fertility and have a baby. At the Royal Surrey County Hospital, Miss Ellis reviews young women with early stage endometrial cancer and those with Complex Atypical Hyperplasia (CAH) ie precancerous endometrial cells, who still wish to retain their fertility.  

She offers a fertility sparing option in the form of medroxyprogesterone. This treatment, if successful, will allow many women to have the chance of having a baby in the future. These young women are closely followed up with blood tests and a repeat hysteroscopy and D & C following 3 months of medroxyprogesterone treatment to assess whether the abnormal cells (cancer cells/CAH) in the endometrial lining have regressed. Miss Ellis recommends that if the cancer cells /CAH have regressed following treatment, a referral is made for IVF treatment as this gives a greater chance of successfully conceiving than trying to conceive naturally.