Can pregnant women get endometrial cancer?

Endometrial cancer is a common gynecological malignancy, and about 5% of cases occur in women of childbearing age under 40 years old. The main treatment is total hysterectomy with bilateral salpingo-oophorectomy or simultaneous retroperitoneal lymph node resection. However, as women around the world prepare to conceive later and people's requirements for quality of life increase, the treatment of young endometrial cancer patients should not only aim to reduce recurrence and prolong survival time, but also maximize the quality of life, preserve physiological function, or even preserve reproductive function on the basis of ensuring prognosis.

Generally speaking, endometrial cancer is a malignant tumor that occurs in the endometrium. However, as the disease progresses, the tumor will gradually invade the muscular layer, and metastasis may begin at that time! Therefore, for patients with endometrial cancer, fertility can only be retained in certain special circumstances!

The prerequisite for preserving the uterus is that the endometrial cancer must be highly differentiated in pathological examination and without any evidence of myometrial invasion. The patient must be young, infertile and willing to be closely followed up for observation.

For patients who intend to preserve their fertility, the following strategies are usually used:

1. First, give a large dose of progesterone treatment, the treatment dose is equivalent to more than 100 times the contraceptive dose. Endometrial biopsy should be performed three months after treatment. If the pathological results confirm that the lesion has improved, it should be used for another three months, followed by assisted pregnancy;

2. If the pathological results three months after treatment indicate that the lesion has not changed, endometrial biopsy will be performed for another three months. If the pathology shows improvement at that time, progesterone can continue to be used for three months, followed by another pathological examination. If the pathological results do not show that the endometrium has been transformed into a normal one, the reproductive function should be preserved immediately; if the pathological endometrium has been transformed into a normal endometrium, assisted pregnancy should be started.

3. If the disease progresses three months after treatment, give up preserving fertility.

Although there have been reports of successful pregnancies achieved through fertility-preserving treatments for endometrial cancer, bringing hope to these patients, there are still many unresolved issues, including: the safety of fertility treatments and the pregnancy rate after treatment, the risk of ovarian tumors while preserving physiological functions, and whether hormone replacement therapy can be performed after iatrogenic menopause.