Patient's Query
Hello doctor,
My sister is 38 years old and was recently diagnosed with early endometrial cancer after a biopsy. She has not had children yet and is hoping to conceive in the future.
The doctor mentioned the possibility of hormonal treatment using Megace instead of immediate surgery.
Is this fertility-preserving approach safe or risky?
How often does cancer respond to hormone therapy like this?
Also, if the treatment works for now, will she still need a hysterectomy later after pregnancy?
We are trying to understand realistic options before making a decision.
Kindly advise.
Hello,
Welcome to icliniq.com.
I understand your concern.
Yes, a fertility-preserving approach can be considered in some women with early endometrial cancer, but it is not suitable for everyone. It is usually offered only in carefully selected cases and requires close monitoring.
Hormonal therapy is usually considered only if the tumor is low-grade (Grade 1) or the cancer is limited to the endometrium (inner lining of the uterus) with no deeper invasion on magnetic resonance imaging (MRI). There is no spread outside the uterus, and the patient is willing to undergo strict and regular follow-up.
The treatment commonly involves Megestrol acetate, which is a progesterone-based medicine. In some cases, it may also be combined with a progesterone-releasing intrauterine device.
In carefully selected patients:
Around 60 to 80 percent achieve a complete response (no cancer seen on biopsy).
Around 30 to 40 percent may have recurrence later.
Because of this, close monitoring is very important, usually with an endometrial biopsy every three to six months. If the cancer responds well, pregnancy is usually advised soon after remission, and fertility treatments may be considered if required.
Even if the treatment works and pregnancy is achieved, hysterectomy (removal of the uterus) is generally recommended after completing childbearing to reduce the risk of recurrence. In simple terms, this approach can help preserve fertility for some time, but it is usually a temporary plan, and surgery is often advised later for long-term safety.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
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Answered byDr. Neha Nigam
Medically reviewed byiCliniq medical review team
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