Born a few months apart, Vander Clark and Baxter Browne are ordinary babies in every respect except one: both were conceived thanks to a radical fertility-saving procedure for cervical cancer.
Invasive cervical cancer is one of the most common and lethal cancers affecting women worldwide. Even if successful, most treatment options come with an unfortunate side effect: infertility.
There’s hope, however. A relatively new procedure, the radical trachelectomy involves the removal of the cervix and the tissue surrounding it. The lower part of the uterus is then directly attached to the top of the vagina.
Unlike traditional options such as a full hysterectomy, the trachelectomy can allow a woman to carry a baby to full term following treatment.
A difficult decision
Kirsty Browne is a fertility specialist, so when she received the news that she had cervical cancer, the possibility that she wouldn’t be able to have a baby was one of her biggest concerns.
“At 26, it was something that I had considered, but being told that I might not be able to have one at all was surreal,” she says.
Approximately 15% of cervical cancers occur in women under 40. For many who still wish to have children, the only option is surrogacy. To Kirsty, this wasn’t entirely reassuring.
“Working in fertility, I knew that surrogacy was an option, but it comes with its own physical, emotional and financial costs, and there is a very real chance it might not work. Also the thought that I wouldn’t be able to carry my own baby was something that really concerned me,” she says.
Balancing risk with reward
Jenna-Lea Clark and her husband Arron had already had a child when she was diagnosed with cervical cancer at age 28, but the decision for them was no less fraught.
The trachelectomy comes with its own risks. “One of the concerns is that [the trachelectomy] might not be as effective in treating cancer as a hysterectomy,” says gynaecologic oncologist Trevor Tejada-Berges.
“Some women will also develop issues in terms of pelvic pain, particularly after menstrual periods,” he says. There is also an increased risk of miscarriage and premature delivery.
In fact, says Trevor, more than half of the women who undergo this procedure ultimately choose not to fall pregnant.
“Even being able to provide that option, where the doors have not completely shut, goes a long way towards making women feel comfortable,” he says.
For Jenna-Lea and Arron, this decision came only months after the birth of their daughter, Summer.
“This was obviously a very complicated and emotional decision for my husband and I to undertake,” she says.
“We were made aware of the risks that a pregnancy would carry and of the complications we could experience, but felt supported in our decision by Chris O’Brien Lifehouse.”
A successful birth
Kirsty Browne was able to fall pregnant three years after her surgery, and her son Baxter was born in November 2017.
Trevor, who performed Kirsty’s original procedure, was present in the delivery room.
The experience was rewarding for Trevor too. “As a gynae-oncologist, so much of what we do is destructive. It’s about taking out a uterus that has cancer, or removing the ovaries if there’s a risk of cancer,” he says.
“To actually do something that is both curative and offers a level of restoration of normalcy was really nice for us.”
The birth of their son Vander inspired Jenna-Lea and Arron to launch SurFebruary, a campaign which managed to raise more than $20,000 for Chris O’Brien Lifehouse last year.
“Lifehouse was honestly a beacon in our darkest hours,” says Jenna-Lea. “I’ve said to many people, you never want to be in this situation, but if you are, we are blessed to have a place such as Chris O’Brien Lifehouse which is so committed to a holistic approach to treating cancer.”
Eradicating cervical cancer for good
The trachelectomy procedure is rare, but according to Trevor Tejada-Berges, it could become even rarer.
With the introduction of the more effective Cervical Screening Test which replaced the pap test in Australia in 2017, cervical cancer rates are expected to drop. Of those who do contract the disease, early detection will hopefully mean they are eligible for even less invasive treatments.
“At the end of the day, what we are all hopeful for is that in 10-15 years we will be seeing less and less cervical cancer as the result of effective vaccination programs,” he says.
For Kirsty, the importance of a preventative approach can’t be understated.
“It’s so important for people to get screened for all cancers when recommended. I am very aware that things could have been so different if I didn’t have a pap smear that day.”