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UNC surgeon one of few performing fertility preservation treatment

Posted May 20, 2015

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— There are only five surgeons in the country qualified to perform robotic trachelectomy, the breakthrough procedure proven to remove cervical cancer without costing a woman her uterus and her fertility.

One of the five is Dr. John Boggess, a gynecology surgeon at UNC Hospitals.

Because of Boggess's work, two moms are raising two sons, and one has another baby on the way.

Crystal Crenshaw and Tonya Caldwell were both diagnosed with cervical cancer before they had the opportunity to fulfill dreams of motherhood.

"They told me I wouldn't have the option to ever have children," Caldwell said.

Most women diagnosed with cervical cancer in the United States are not offered an option other than a radical hysterectomy, removal of the reproductive organs. But if cancer is found early enough, there is another option.

With a hysterectomy, the cervix and the entire uterus are removed. With a trachelectomy, Boggess uses robotic tools through three small incisions in the abdomen to remove most of the cervix.

"But instead of removing the uterus with it, we need to preserve part of the cervix that we can then reconstruct back to the vagina," Boggess explained.

A sort of "draw string" is stitched in the bottom of the uterus so that, in case of pregnancy, the baby will remain inside.

"It's estimated that about 40 to 45 percent of women we treat for cervical cancer are candidates for this procedure," Boggess said.

While the procedure is tricky, it is minimally invasive for the patient and most women go home the next day after surgery.

Over a period of 7 years, Boggess has done 30 such operations. All of those patients are cancer-free. Five have had babies.

Boggess keeps in close contact with his successes.

"I tell them, you can tell grandma, and then you got to tell me when you get pregnant," he said.

Caldwell is among his grateful patients.

"Thanks to Dr. Boggess and the good Lord, I have Elijah, and I have this sweet baby on the way," she said.

How big a problem is cervical cancer?

According to a study in the Annals of Oncology, cervical cancer is the world's third leading cause of cancer women. The National Institutes of Health that, in the United States, cervical cancer is not even in the top 10. It's 14th.

That is likely because more boys and girls ages 11 or 12 get the recommended Human Papilloma Virus vaccines which prevent cervical cancer and the many other health problems that HPV infection can cause.

Health officials also credit American women 21 years and older who get recommended Pap Smear tests every 3 years for early detection.

Still 15,000 women are diagnosed with cervical cancer.

When the cancer is detected early enough, those women now have a surgical option to both cure the cancer and preserve fertility.

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