The Current - Saving women’s fertility during cancer treatment

Episode Date: June 23, 2026

The first uterine transposition, a minimally invasive surgery that temporarily relocates your uterus into your upper abdomen, was performed in Canada on a young woman in Montreal earlier this year. The surgery was designed to help young women battling specific types of cancer around the pelvic area preserve their fertility, which is typically lost during radiation therapy. We speak with Dr. Reitan Ribeiro, who pioneered this surgery in 2017 and performed the first surgery in Canada this year, and Denise Maradona, an early patient of Dr. Ribeiro's who received one of the first ever uterine transpositions in Brazil back in 2018.

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This is a CBC podcast. Hello, I'm Matt Galloway, and this is the current podcast. Brittany Fecto was only 28 years old when she was diagnosed with cancer earlier this year. Hodgkin's lymphoma in the groin. And then she got more bad news. Her doctors told her the cancer treatment she needed, radiation to her pelvic area, would cause her to lose her fertility and go into early menopause.

I'm a mother to a six-year-old boy. It was right where my ovaries and uterus were. The radiation was going to destroy everything. But my savior arrived. That savior was Dr. Ratan Ribeiro, a gynecologic oncologist at the McGill University Health Center in Montreal. Dr. Ribeiro pioneered a procedure to preserve fertility in women undergoing cancer treatment.

In February, Brittany became the first Canadian to undergo that procedure. It's called a uterine transposition. Dr. Rivera joins us now from Montreal. Dr. Good morning. Hey, good morning. Thank you so much for having me. Thank you for being here. This is a fascinating story.

What exactly will begin at the beginning? What exactly is this procedure? What is a uterine transposition? Yeah, so this is a procedure to preserve when it's fertility. It's a procedure done in two steps. So we have one minimally invasive surgery. It's done with the laparoscopy or robotic surgery. We mobilize, so we take the uterus out.

of the pelvis and we place the uterus in the upper part of the abdomen right in front of the stomach. So the patients can go through radiation and then once they are done with the radiation, we have a second surgery. We take the uterus from the upper abdomen and we place it back in its natural position. And we do that because radiation causes like ovion failure and also fibrosis to the uterus and other problems. So those patients, they cannot get pregnant by themselves. Usually they need surrogacy. So it's like a way of preserving the uterine function. I'm not a surgeon, but you said something that I think is really important,

which is you say this is a minimally invasive procedure? Yeah, because we use a, well, it depends. It might be too much when they say minimally invasive. What we mean is the patients don't need that big incision in the abdomen. They can do it through laparot. or robotic. So they have four or five small incisions between half and one centimeter in the abdomen. And usually we keep them at the hospital for a couple of days.

But actually, they could go home the day after the surgery. And usually they can resume their daily activities like once they go home. And that's why we call it minimum invasive, despite of the procedure being not that small. I would say it's a medium type of surgery. But recovery, it's quite fast in general. You pioneered this technique in Brazil back in, what, 2017? Yeah, 2017, almost 10 years ago. Yeah.

And you have said that when other surgeons have heard about this, they kind of thought, well, why didn't I think of this? Yeah, that's the, when I thought about it the first time, I also had the same reaction. I said, no, someone had, you know, have done it before. I'm not going to do it for the first time. I can't believe it never happened because it's kind of obvious.

Because there were two other surgeries that we used to do very often, like mobilizing just the ovaries or taking the cervix and mobilizing just the uterus in the pelvis. But then I realized that combining those other two procedures that could create a new one. And that's the obvious part. It's like combining two things that you see like every day in a different thing. And that's why when we presented for the first time, most of the decisions were like, oh my God, this is so obvious. Why did I think about it?

And that's it. It's just because it's a combination of other two procedures. They are common procedures. Why did it take so long for it to be performed here in Canada? Well, there is always because in Brazil we did the research part of, the development of the procedure. So the research itself took almost five years. And then other countries started doing research, like in the U.S.,

and now it's a procedure that's been adopted in many places, a standard of care. So I think it was mainly because there is this moment of research that most of the institutions will wait and see if it works, if it doesn't work, and can you offer it safely? And then once I got here, because I was hired to do those things, then we just moved on and started doing it. What made Brittany Fecto a prime candidate for the surgery?

Well, she's the perfect candidate because she had a tumor that wasn't affecting the uterus ovaries and tubes. So it means the reproductive organs are normal, So there's no reason to lose your fertility when you have like normal reproductive organs. And she needed radiation. She would lose her fertility because of the radiation. So that's the kind of patient we are looking for because they can treat their cancer. They don't need to change anything about the cancer treatment. And we can still offer preserving fertility, you know, preserving their future and their wishes and all that.

And she was very into it. And she was, and now the family, it's a family thing and the husband and, you know, everyone. So she's the ideal candidate because of this rare combination of things. You would have heard her, she said this before, but at the beginning of our conversation, she said her savior arrived. You were the savior. That might be too much, to be honest. But I'm happy that she's happy.

But how does it feel to hear that? She thinks that you've changed her life in many ways. I'm very grateful. I mean, this is awesome. I still, most of the patients, they speak to me, like 10 years, almost 10 years after the first case, I still get text messages, you know, every Christmas and things like that. And we create a special bond with the patients. They send pictures of kids and stuff like that.

So I feel connected in a different way. So I'm the kind of the weird uncle, I guess. You know, and this guy, in some way we are connected. And I feel like the patients understand that because I'm not the one treating their cancer. And I'm the guy offering you something that nobody's offering. And then, you know, listening to the patient sometimes. And I mean, all the doctors, they do it. But sometimes we are in a rush.

Sometimes we don't, you know. And then someone is coming and saying, listen, I can help you with something that's going to, you know, life goes on. You treat your cancer. Let's take care of your life, you know, your future. And then we create this bond. It's very special. The spirit of innovation is deeply ingrained in Canada. And Google is helping Canadians innovate in ways both big and small.

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Let's take action for the planet and let's take it together. Sign up at hikefor hope.ca. So I want to hear from one of those other patients that you have treated. Denise Maradonna is a former patient of yours from Brazil, one of the first women to ever receive the surgery in 2018. She's in Washington State this morning. Denise, good morning to you. Good morning. Do you think the doctor was your savior?

Oh, yes, sure, yeah. Yes, well, because of this treatment, because of, Dr. Rivera was possible for me and my husband have my son, and he is almost far now, almost four years old. Yeah, so it was great. Go back to 2018. You were diagnosed with cancer when you were 35 years old. Yeah, exactly. Tell me a bit about your diagnosis. Yeah, well, I was, like you say, 35 years old, and I received a diagnosis of rectum cancer. And then they told me that I have to have the radiation therapy,

and this is going to cause infertility. That time, I already had a daughter. She was two years old. And also they say that I were going to have the menopause, early menopause, because of the radiation. And then the doctor at that time told tell me about Dr. Ribeiro. and then I had appointment with him. Yeah, but I was very in shock to receive that diagnosis that time.

Why did you decide to have this procedure? Why did you decide to have the uterine transposition? Well, at that time, I was not really thinking about have more kids that time because when received that diagnosis, I was really shocked. But anyway, I think that it was better

to protect my uterals. I do not want to have. early menopause and I would like to keep my uterus health anyway and then in the future I could decide if I would like to have more kids or not. So anyway, I'd like to help it with the research and technique and so I decided to say yes and make the procedure. Did you say yes immediately? I think it was maybe one, yeah, I think it was, I think I think maybe some hours or, I don't know, maybe one day, but yeah, I do not think too much about it.

I just, I think after the appointment with him, I make the procedure, I don't know, maybe in the same week, yeah. The procedure is involving moving your uterus, and so your uterus was in your upper abdomen for almost four months or so during this treatment. Yes, yes. What does that feel like? Yeah, you know, it's not too much different. You know, I don't, I do not feel nothing different. I think only in the end of this period about four months, you start to feel a little bit of a slight discomfort

because I think it's like when you eat so much and you feel poor. It's something about that, but nothing, no pain, not a big discomfort. So, yeah, it was not, it looks like that you feel different, but no, it was not a bad sensation. And then in 2021, you got pregnant again. Yeah, I got pregnant in the end of 21. And, yeah, and my son born in 2022, and he's almost. for now. When you look at him and you think of what you've gone through, what goes through your mind?

Oh, I think it was very, very blessed to have my son. And I know now that I did the correct decision when I set to do this procedure. Even though it was something new, now I'm really sure that I did the correct thing because, yeah, you know, my son, he is just amazing. So I'm very, very happy and feel blessed to have him and to have this opportunity from Dr. Ribeiro. Did you tell Dr. Ribeiro that you were going to have another child? Yes, he was, I think, the first person that my husband and I decided to tell, because I was really sure he's going to be very happy with his new. And, yeah.

Doctor, when you got that news, what was your reaction? Oh, my God. It's so good to hear Denise again, because, you know, I keep exchanging text message with her husband, and we became like friends, I guess, despite of him being Argentinian. So it's so good. But it's very, very, I can't explain how happy I got when I got her text. And then the photos when the baby were born. And I was keeping track during pregnancy, you know, exchanging.

in text messages with her husband. Anyways, it was very, very special. And she helped so much. And this is the kind of thing that you don't think about it when you see, like, paper or research about it because those patients, they go through a lot. I mean, it's when you got a diagnosis from cancer, it's just like everything else, you know, just disappears. And then, you know, taking your time and saying,

you know what, I'm going to try this. I'm going to try this. This is very, they need to be unique. Those are very special women. These is not a, those are not regular people. And, and this is very, that's why I really appreciate having, you know, the chance of doing that. Can you just talk, you, you said something earlier, which was really interesting. And it was about listening to your patients. And in another interview, you said that it's important to to listen to your patients in part because the truth is, once the cancer treatment ends, the patients go back to their normal lives and that they're going to get through this and life goes on.

What does that say about why something like this matters? Because, you know, treating cancer is tough enough. And then, but when the patients finish their treatment, they started having the same issues of, you know, everybody. And for many of them having kids is a main part of their life. It's like for some people, that's the reason why they are in life. And because most of them will be cured. And then you have this scar, which is the cancer,

and you're going to get through this, and most of the patients will get cured. But then you have a scar that you can never get rid of, which is losing your fertility. And this is going to be forever. And for some patients, this is the hardest part about treating cancer is when they realize, oh, I lost my chance of having kids. Or sometimes they can have also eggs or stuff, but they cannot carry the pregnancy.

And that becomes a big issue in their lives. And some patients, they actually never recover from it. They get depressed. Sometimes the family is destroyed because, you know, the husband wants to have a kid. They can't have it. They feel like they didn't enough. So what Denise said is very important because she wasn't very into having kids. And sometimes when you have a diagnosis of cancer, everything else just doesn't matter anymore.

You think you're going to die and then you don't realize. And as a doctor, you need to hear the patient and you need to give them an explanation of what's next. I know it's tough. You're going to get through treatment, but there is life after cancer. And then you have to deal with yourself. Now it's you in life and what you want from your life after treatment. And I would say for most of young women, they want to pursue. their fertility, that's a very important part of their life.

So I think that's the kind of decision that is very hard, and that's, and it's hard for the doctors because you need to, it takes like one hour with a patient at least to explain something like that. And sometimes we are in a rush. It's just life, it's hard. But in the end, that's a very difficult decision. They need to go through all this, but, you know, there's a big reward. it's a big thing.

This is the first time the surgery's been done in Canada. What will it take? We're almost at a time, but just briefly, what will it take for the surgery to become available to more women? Well, I'll say now it's a matter of doctors accepting it in a rising awareness, I guess, because I got texts for patients that lose the chance of doing the surgery because they text me after radiation,

they say, I didn't know I was going to lose my fertility. But other than that, Canada, every cancer center has everything, it's necessary to do it. So you just need a gynecologist, oncologists. You need a minimally invasive equipment for surgery, and you need someone with time to talk to the patients. That's all you need. So hopefully, once we started doing it in Canada, hopefully other centers will be able to offer. Denise, you have a connection with this doctor for the rest of your life, I guess, eh? Yeah, so, yeah, absolutely.

Yeah. Yeah, I'm very grateful. What a remarkable story, and I'm glad you're doing well, Denise. Yeah, yeah, I'm doing well. Cancer-free for eight years. Fabulous. So far. Yeah.

It's an amazing story. I'm really glad to talk to you. Denise, thank you very much. Oh, thank you. And Dr. Ribeiro, thank you. Thank you so much. Denise Maradonna was one of the first women. in the world to receive a uterine transposition. She was in Washington State. Dr. Raton-Rabero is a gynecological

oncologist at McGill University Health Center. He was her doctor. He performed the first surgery of that kind here in Canada. We reached him in Montreal. You've been listening to the current podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcasts, go to cbc.ca slash podcasts.