New surgery in Nevada preserves fertility in cancer victims

Friday, Oct. 1, 2004 | 4:23 a.m.

WEEKEND EDITION

October 2 - 3, 2004

For 27-year-old Jennifer Cecil of Las Vegas, the news that she had cervical cancer dampened hopes of conceiving a second child. Until, that is, a local medical specialist tried a rare medical procedure for the first time in Nevada.

Nine months ago Cecil, a bartender at La Bayou on Fremont Street, learned she had cancer in her cervix after a routine examination.

The typical cure for cervical cancer is a total hysterectomy, an operation requiring surgeons to remove a woman's cervix, womb, top of the vagina and all lymph nodes around the womb, ending both the cancer and any chance for her to bear children.

Although Cecil has a boy, 7-year-old Alex, she wanted "just one more" child.

Dr. Robert Futoran, an obstetrician, gynecologist and oncologist who teaches doctors how to deliver babies, heal women's illnesses and battle cancer, had learned how to remove a woman's cancerous cervix in an operation called a radical trachelectomy.

"What you're really trying to do is save patients' lives," Futoran, director of gynecological oncology at Sunrise Hospital and Medical Center, said on Thursday, standing beside Cecil as she reclined in her hospital bed.

Requirements for undergoing a radical trachelectomy include catching the cancer at its earliest stage and having no sign of the disease in the patient's lymph nodes.

"We're very selective of the patients," Futoran said. If the cancer had spread through Cecil's cervix or to her body's lymph nodes, she would have needed a total hysterectomy.

A total of 20 patients have undergone the procedure in the United States, Futoran said. Of those patients, seven became pregnant.

For Cecil's part, she approached her future with the idea of having a second child.

"I didn't know it was possible at all," she said of the surgery.

Futoran consulted with Dr. Nicola Spirtos, whom he had met at UCLA before moving to Las Vegas 12 years ago. Together the specialists decided Cecil was an appropriate candidate for the surgery.

Cecil went home from the hospital on Thursday and should be back on her feet in two weeks. Recovery can take up to six weeks.

"Each cancer is different, each woman heals in different times. I usually tell them to do whatever they feel like doing," Futoran said. "She did want to preserve her ability to have children; chances are good she will get pregnant."

Cecil will need an exam every three months for the next three years, more than the once-annual pap smear recommended for most women older than 18. If the cancer doesn't reappear in two years, it is unlikely she will develop the disease again, Futoran said.

Sunrise Hospital and Medical Center treats adults and children in its certified comprehensive cancer program. In 2004 more than 1,000 cancer patients were treated, Cheryl Smith, director of marketing for the hospital, said.

Dr. Daniel Dargent of Lyon, France, pioneered the radical trachelectomy technique and bilateral lymph node dissection. Between 1987 and 1995 he operated on 470 women.

Of 16 patients who tried to become pregnant after Dargent performed their surgeries, 10 delivered a normal baby. One woman died of a progressive disease.

Cervical cancer claimed the lives of 345 women in Nevada from 1970 to 1994, the last year statistics are available from the National Cancer Institute. Nevada ranks 20th among the 50 states for cervical cancer deaths.