With innovative treatments and survival rates on the rise, more women can beat cancer and plan for a family in the future, too.
To understand how gynecologic cancers — like ovarian cancer and cervical cancer — affect fertility, we spoke with board-certified gynecologic oncologist Nathalie McKenzie, MD, director of the gynecologic oncology fellowship at the AdventHealth Cancer Institute.
Dr. McKenzie actively researches fertility preservation during cancer and, through her practice, shares compassionate empathy with her patients as a cancer survivor herself.
How Does Cancer Affect Fertility?
While cancer can damage a woman’s reproductive organs, treating gynecologic cancers can also harm a woman’s ability to have children. “Either the surgery, chemotherapy or radiation can ultimately affect a woman’s fertility,” says Dr. McKenzie.
“If the ovaries are near or within a radiation beam, it won’t take long for the radiation to render the ovaries non-functional,” she explains. In other cases, some women may have to have their reproductive organs removed entirely to reduce the risk of cancer spreading to those areas.
For women diagnosed with any form of gynecologic cancer, Dr. McKenzie offers them not only advanced treatments personalized to their needs, but also empathetic care that stems from her own experience with cancer.
Dr. McKenzie was diagnosed with metaplastic ductal carcinoma, an aggressive form of breast cancer, just days before her 31st birthday. “Thirty-year-olds aren’t supposed to have cancer, I thought at the time,” she explains. “I immediately started thinking about my fertility,” she said, as she was recently married and hoped to have a family.
With the support of fellow physicians, friends and family members, Dr. McKenzie went through mastectomy surgery and chemotherapy and, through a specialized treatment, she didn’t have to sacrifice her ability to have children in the future.
Preserving Fertility While Managing Cancer
Depending on the diagnosis, a woman may need to act quickly to protect her fertility and talking with an oncologist can help her take the necessary steps to do so.
“Often, patients have a small window of time after diagnosis and before starting these treatments,” says Dr. McKenzie. “What’s particularly important is for the multidisciplinary team to have a discussion with these women whereby they offer resources — and education — so that patients are empowered to make timely decisions for themselves.”
After receiving her breast cancer diagnosis, Dr. McKenzie knew that she needed to start treatment quickly, but also wanted to make sure she could conceive later on. Before starting chemotherapy, Dr. McKenzie discussed her plans for a family with a specialist — a step that she recommends to all women who face a cancer diagnosis.
“Preserving a woman’s fertility requires an evaluation and discussion with her gynecologic oncologist, a fertility specialist and other members of her oncology team,” she says.
With the guidance of these experts, a woman can choose the method that best fits her diagnosis and timeframe before starting cancer treatment. Women may choose to freeze their eggs or a fertilized embryo (or even ovarian tissue), or they may opt for specific drug therapies during treatment.
“I discussed my desire to start a family with my oncologist. His recommendations were to suppress my ovaries — and my menstrual cycles — with a drug that does just that,” she said. Dr. McKenzie chose fertility treatment with the drug Zoladex, which made her ovaries temporarily dormant, protecting them for the future.
Dr. McKenzie chose this method to avoid delaying the start of chemo. She points out that today, 15 years later, fertility-preserving techniques have evolved, giving women more options to protect their fertility before cancer treatment.
“During the time that I received chemotherapy, my ovaries were suppressed, and I believe that may have played a role in allowing me to have my two children later on.”
Is Natural Conception Possible After Cancer?
Some women who are in remission from gynecologic cancers have children naturally, but unfortunately, it’s still somewhat rare. “Depending on the treatment and the type of cancer, it’s not always possible. More often than not, they’ll need varying degrees of assistance,” Dr. McKenzie explains.
However, as reproductive medicine continues to advance, more fertility solutions could soon be on the horizon for women who face aggressive cancers. In some centers around the world, uterine transplantation is being explored, Dr. McKenzie says, and the medical community awaits the success of this and other intriguing strategies.
Fertility Care and Cancer Treatment Customized to You
Fighting cancer with fertility in mind starts with a team of experts that rally around you.
“It’s a collaboration between the patient, her treating oncologist and a fertility specialist,” says Dr. McKenzie, which is how she and other members on her team partner with patients. “It takes a team of people, each with their area of expertise, to come together to devise a well-thought-out plan for each patient, based on their unique characteristics.”
Through Dr. McKenzie’s practice at the theAdventHealth Cancer Institute, women receive personalized care that helps them survive cancer and plan for their future families, too. “Our physicians put a lot of thought into surgical strategies where sometimes fertility can be preserved, and they consider treatment strategies that decrease the likelihood of ovarian failure during treatment,” she says.
“We approach our cases through multidisciplinary care, so our patients have multiple experts from different disciplines within cancer care, each looking at the same case to provide that comprehensive outlook and perspective that really gives patients the best care possible.”
To give her patients the best possible outcomes, Dr. McKenzie is highly skilled in minimally invasive and robotic-assisted procedures for women with all types of gynecologic cancer. Additionally, she is well-versed in fertility-preserving radical trachelectomy, a specialized procedure for women who have early-stage cervical cancer.
For Dr. McKenzie, her past cancer diagnosis inspires how she cares for women every day. “I went through a horrifying personal experience and I had to gather strength and knowledge to do so. I am blessed now, as a cancer expert in gynecologic oncology, to offer that strength and experience to my patients — it’s an incredible blessing.”
If you or someone you love faces a cancer diagnosis, we’re here to help you through compassionate cancer care from experts you can count on. Learn more about Dr. McKenzie or read more about our gynecologic cancer programs in your area.