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Cervical Cancer — SCE Medical Oncology MCQ

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HardGynaecological CancersCervical CancerSCE Medical Oncology

A premenopausal woman is about to start curative pelvic chemoradiotherapy for locally advanced cervical cancer and wishes to have children. Treatment has not yet begun. What must occur urgently without compromising cancer treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Explain the gonadotoxicity and refer for oocyte or embryo cryopreservation assessment before treatment

Explanation lettering: E = shown as A · D = shown as B · B = shown as C · A = shown as D · C = shown as E

C is correct. NICE NG257 recommends offering oocyte or embryo cryopreservation, as appropriate, before treatment likely to cause infertility. Referral must be urgent and coordinated so curative therapy is not inappropriately delayed. Pelvic radiotherapy damages ovaries and uterus; ovarian transposition can reduce ovarian dose in selected patients but cannot guarantee function or restore uterine capacity. IVF is not prohibited simply by the diagnosis, fertility-sparing cervical surgery is for carefully selected early disease rather than locally advanced cancer, and reassurance that fertility is usually preserved is false. Discussion should include gestational-surrogacy implications where uterine irradiation is expected.

Reference: NICE NG257 fertility preservation for medical indications: https://www.nice.org.uk/guidance/ng257/chapter/Fertility-preservation-for-medical-indications