Move the uterus and ovaries, position them in a different point of the abdomen to prevent them from being irradiated during radiotherapy sessions, so as to save them from side effects that could compromise the patient’s fertility.
And once the cycle of oncological treatment is finished, relocate them to their natural location.
This is what a multidisciplinary team from the Gemelli Irccs University Polyclinic Foundation in Rome made up of gynecological oncologists, radiotherapists and general surgeons did, for the first time in Italy, in a cutting-edge operation, which has only about twenty precedents, performed on a young woman who had to undergo chemo-radiotherapy for rectal cancer.
THE CURE
As reported in a work published in the International Journal of Gynecological Cancer, coordinated by Nicolò Bizzarri, medical director at the UOC of Oncological Gynecology and researcher at the Catholic University, first operator of uterine transposition and repositioning operations and first author of the article, it is an operation that has the aim of preserving fertility in young women suffering from oncological pathology in the abdomino-pelvic area, allowing them to undergo life-saving treatments and preserve their fertility.
A hope, therefore, against the most recent epidemiological evidence which shows how the cases of young people diagnosed with cancer are increasing. For example, according to data from the American Cancer Society, in the United States colorectal cancer is the third most diagnosed cancer in both men and women and, in 20% of cases, it affects individuals under 55 years of age.
Furthermore, it represents the first cause of death from cancer in young men and the second in women, behind only breast cancer. The data show, in fact, that since the mid-1990s there has been a constant annual increase of 2% in diagnoses in the 20-39 age group following, according to experts, an increasingly sedentary lifestyle and a greater consumption of processed foods.
Oncology therapies, although essential for recovering from tumors of the rectum, anus, bladder and cervix and ensuring survival, can however compromise fertility. Radiotherapy, in fact, by acting on rapidly dividing tumor cells to slow down their growth and eradicate them, can also affect the healthy cells found in the tissues surrounding the cancer and which the radiation passes through to reach the tumor.
When radiotherapy is directed at the pelvis, it can therefore damage the ovaries, reducing the number of eggs, and the uterus, compromising the muscle layer surrounding it, causing this tissue to lose its ability to stretch and expand during pregnancy.
AND YOURS
Radiotherapy can also negatively affect the vessels that supply blood to the uterus, with possible consequences for the development of the placenta during gestation. The uterine transposition technique could therefore represent a revolutionary option, capable of changing the quality of life of patients suitable for this type of operation, providing an additional option to preserve fertility, in addition to those that have been available until now, such as oocyte cryopreservation.
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