Achievements

The CFS physician/scientists have systematically tackled problems that affect cancer patients and many other women. With the traditional medical approach, cancer cures sometimes come at the expense of quality of life, and especially at the expense of fertility. CFS research efforts have introduced gentler alternatives that protect fertility through each stage of disease management including diagnosis, prevention, treatment and if necessary, even “salvage” therapies.

Diagnosing cancer often requires an invasive biopsy. In the case of female genital cancer, the biopsy is often a dilation and curettage or “D&C”. Although the D&C may be the gold standard for diagnosis, it can actually rob a woman of her fertility by damaging the womb. CFS introduced a very delicate replacement biopsy procedure that has virtually eliminated the need for a D&C in some practices. The “endometrial brush biopsy” has been used in thousands of patients without complications or loss of fertility.

Preventing cancer can be achieved only by first accurately diagnosing it through the “brush”. Once a pre-cancerous condition is diagnosed, non-toxic preventative treatments can be used. For instance, the standard treatment of an abnormal Pap smear is to destroy part of the cervix where the Pap smear comes from. Millions of women each year have abnormal Pap smears. Current therapy is effective but exposes women to impaired fertility and increases the chance of preterm delivery dramatically. CFS collaboration has introduced the first randomized clinical trial of a vegetable derivative, made entirely from cabbage! When taken as a pill for 12 weeks, up to 90% of women will improve! No destructive treatment was needed in nearly all of the women in this landmark study.

Treatment for actual cancers will always be needed despite these breakthroughs in diagnosis and prevention. CFS has developed new medical treatments and surgical techniques for treating patients with cervical cancer, designed to preserve fertility without compromising cancer treatment. The organization has also worked to develop new medical therapies to avoid surgical impairment of fertility, together with new treatments for pregnant women with cancer.

CFS has greatly improved the radical trachelectomy. The radical trachelectomy is the most widely used technique to preserve fertility while treating cervical cancer. A few centers, including our group of surgeons, started doing this surgery in the early 1990’s. However, for many women this challenging operation was not available in their country. Something had to be done to simplify the trachelectomy so that women everywhere would have access. Through years of research and testing, the CFS surgeons were able to ‘re-invent’ the trachelectomy technique so that specialists all around the world could learn and use it. Now the same cures and fertility preservation techniques that are available to women in North America, are available to women in developing countries

Salvage is the last hope for many cancer patients. In 2005, the Society's surgical team performed the first abdominal radical trachelectomy in the United States, on an eleven week pregnant patient. Her pregnancy was still viable after successfully removing the tumor and her future fertility was preserved. In the unfortunate patient who must have a hysterectomy or for women who are born without a uterus, perhaps the ultimate salvage option is reproductive organ transplantation.

The ultimate goal of uterine transplantation is to salvage a woman’s fertility when all else has failed. Adoption is encouraged, however, for some women adoption is not an acceptable choice. CFS prior research efforts have now led us to the point of interviewing patients to receive a human uterine transplantation. Working through traditional organ donor networks, the surgeons of CFS have conducted preliminary surgeries in preparation for a uterine transplantation. Candidates for the transplant are working their way through the extensive preoperative process right now.

Through CFS medical interventions, cancer can be better diagnosed, prevented, treated and patients salvaged. However, even when these advances work perfectly, some patients will have unrelated secondary infertility. To address the impaired fertility of cancer patients, CFS has revolutionized assisted reproductive techniques such as IVF (in-vitro fertilization). Until the work of the CFS, infertility treatments were the privilege of a small group of fortunate patients. Through the development of new medical treatments that are less invasive, safer and less expensive, more cancer survivors can have access to the latest IVF techniques.

Projects in Development:

New techniques in surgery to treat pregnant patients with cervical cancer with successful preservation of pregnancy
Ovarian transplant as a technique for restoration of fertility
Uterine transplantation for restoration of fertility
New Cancer and Fertility Center at New York Downtown Hospital