Doctors Try New Cervical Cancer Technique

Thursday, May 13th 2004, 11:12 am

By: News On 6

EASTPOINTE, Mich. (AP) _ A woman who gave birth while in the early stages of cervical cancer may be able to have more children someday, thanks to a pioneering surgical technique developed in part by two physicians from Wayne State University.

Nicole Bertorello underwent surgery seven months after the cancer was diagnosed in mid-2002, and four months after daughter Sidney was born. When her doctor tried to operate, she started to hemorrhage.

The only option seemingly available to the Eastpointe resident, then 28, was a radical hysterectomy, which would leave her sterile.

``I cried,'' Bertorello told The Detroit News for a Thursday story. ``It wasn't even the cancer I feared. I'd had thyroid cancer when I was 18, and I wasn't afraid of it. But (to) tell me I'll never have any more children ... even just thinking about it, I get emotional.''

About 500,000 cases of cervical cancer worldwide, including 15,000 in the United States, are diagnosed annually. Treatment customarily involves a complete hysterectomy or radiation or chemotherapy that leaves patients unable to bear children.

In Bertorello's case, however, a second opinion led to Dr. Robert Morris, who told her of an experimental surgery in France where most of the cancerous cervix is removed and the vagina is reattached directly to the uterus.

``I told her about it, and I said, `But I've never done it before,''' Morris recalled. Said Bertorello: ``All I heard was `childbearing.' That I still could be.''

Morris and Dr. Adnan Munkarah, a fellow research doctor at Wayne State, went on to perform a cervical trachelectomy on Bertorello, who paid at least $4,000 out of her own pocket to have the surgery. She is one of a handful of American women to undergo the procedure, which has been done fewer than 200 times worldwide.

In the year since Bertorello had the surgery, she's returned to the hospital for relatively minor procedures _ loosening or tightening a band that separates the uterus from the vagina. Her next pregnancy, if there is one, will be high risk. She likely will need a lot of bed rest and will have to deliver by Caesarean section, Munkarah said.

``The exact rate of success (for pregnancy) is hard to say. But the precautions are the same as having had a preterm delivery in the past,'' Morris said.

An estimated 5,000 U.S. women a year may choose the surgery once it becomes more widely available, researchers say.

The procedure is not fundamentally different from other surgeries they perform, Munkarah said. ``We know the locations. You draw the plans in your mind like a good architect,'' he said.