Uterine Cancer Patient Chooses Innovative Treatment that Preserved Her Fertility
| Three years later, she is the mother of a miracle baby girl
For 20 years, Mother’s Day was one of the hardest days of the year for Alicia Simpson. She loved celebrating the special day with her mother but did so believing she could never have a child of her own.
Simpson has polycystic ovarian syndrome (PCOS), a hormone disorder that predisposes up to 15% of women worldwide to infertility, weight gain, high blood pressure and cancer.
“When you get told that you have PCOS and you’ll never be able to have a child, that hurts,” said Simpson, 39, of Hot Springs.
Though they longed for a child of their own, she and her husband, Jessy, found joy in spoiling their dogs, Loki and Shadow, and 11 nieces and nephews.
In 2021, Simpson’s life took an unexpected turn when her gynecologist discovered suspicious polyps during a routine exam. After further testing at the Gynecologic Oncology Clinic at the University of Arkansas for Medical Sciences (UAMS) Winthrop P. Rockefeller Cancer Institute, doctors discovered a 1.7-centimeter tumor in her endometrium and gave her the news that she had Stage 1 uterine cancer.
Also referred to as endometrial cancer, uterine cancer is the most common gynecologic malignancy in the U.S.
“When you hear cancer, it’s a devastating shock. It doesn’t matter what type of cancer it is. Of course, it was not what I wanted to hear,” Simpson said.
The recommended treatment for early-stage uterine cancer is a total hysterectomy, which would eliminate any chance that Simpson could ever conceive.
“Because I had never had a child, I wasn’t ready for that. I wanted to understand all of my options and do what I could to have a child,” said Simpson.
Fortunately, her UAMS gynecologic oncologist, Heather Williams, M.D., was aware of a research study from MD Anderson Cancer Center in Houston, where women who wanted to have children and were treated with progesterone were able to have their cancer resolved and later conceive.
Williams delivered the good news to Simpson that there might be a way to treat her cancer and preserve her fertility. She elected to delay a hysterectomy and instead opted for hormone therapy delivered through an intrauterine device (IUD) placed in her uterus.
“The IUD goes to where the tumor is, so there is less systemic absorption that could cause side effects,” said Williams.
“Endometrial cancer is estrogen-driven, so we also gave her a medicine that put her into menopause and shut down her entire system so that it would stop feeding the cancer, essentially starving her body of estrogen.”
Treatment also included a dilation and curettage procedure— the most thorough method of clearing the lining of the uterus — every six months to make sure the IUD was working.
“During the whole time, I counseled her that the cancer could spread at any point, and she was still taking a risk, although it is a slow-growing cancer,” said Williams.
“I love Dr. Williams. She’s very thoughtful and thoroughly explained the type of cancer I had and how it would affect me. The fact that she really listened to me and understood where I was coming from meant everything,” Simpson said.
Simpson rapidly improved. Within nine months, her scans were clear.
“After doing several rounds of biopsies and maintaining the hormone therapy and watching it, an MRI showed no signs of cancer at the end of 2023,” said Williams.
Simpson was lucky — about half of all women with uterine cancer don’t respond to fertility-preserving cancer treatment and need a hysterectomy to control their disease.
Finally, almost a year after the diagnosis, Williams gave Simpson and her husband the green light to try having a child. They moved forward with intrauterine insemination (IUI) treatments at Arkansas Fertility Center, where her husband’s sperm was surgically implanted in her uterus.
She conceived on April 15, 2024, on her third IUI treatment.
On May 2, 2024, Simpson took a pregnancy test at work. “I kind of questioned it at first and went to a co-worker and asked, ‘Am I looking at this right?’”
Arkansas Fertility confirmed with an ultrasound that she was indeed pregnant.
“We were all in shock,” said Simpson.
Williams worked closely with physicians in the UAMS High-Risk Pregnancy Program to monitor Simpson and ensure her cancer was under control during the pregnancy.
After going into preterm labor at only 20 weeks, Simpson had a procedure to close her cervix to give the baby an additional six weeks to develop.
After her water broke on Oct. 17, she was airlifted to UAMS Labor and Delivery.
“That was my first time being on a helicopter,” said Simpson.
Weighing 3 lbs and 2 ounces at birth, Amora spent three months in the UAMS Neonatal Intensive Care Unit
Her daughter, Amora Faith, was born at UAMS at 5:29 a.m. Oct. 24, 2024, at 29 weeks, weighing only 3 pounds and 2 ounces. She stayed in the UAMS Neonatal Intensive Care Unit until Dec. 21.
The Simpsons were finally able to take their daughter home right before Christmas.
Amora is now 6 months old and thriving.
“Even today, I look at her and I’m like, ‘I can’t believe she’s here,’” Simpson said.
“She’s done amazing,” Simpson said of Amora’s progress. “You would never know she’s a preemie baby. She’s growing the way she’s supposed to be growing. She’s surprised everyone by how well she’s done.”
Though the journey to get there was difficult, Simpson says becoming a mother is still a dream come true.
“I love every minute of being with my daughter — to love on her, talk to her and hold her. It’s been amazing.”
“She’s the first patient I know of to get pregnant after having her cancer go away,” said Williams. “Personally, it’s been amazing to be able to walk someone through that journey and then have them holding this beautiful, living, breathing little human. It’s a miracle.
“Sometimes we need to listen to our patients and give them a chance if they think their body needs more time,” said Williams.
“We see more and more patients who are younger and in their childbearing ages and not even in relationships yet, and they want to have the option for pregnancy later,” she said. “It’s hard to have these conversations with patients about losing their womb, but at least we can share Alicia’s story and give them hope.”
Because women with uterine cancer are at an elevated risk for the cancer returning after childbearing, Williams recommended to have an IUD placed back in right after Simpson delivered Amora. The hormone therapy is keeping her cancer at bay — an MRI done on April 8 showed no signs of cancer. Eventually, Simpson will need a hysterectomy for a durable, long-term cure.
Williams says it’s important to better educate young women about the normal menstrual cycle so they know something is wrong if they are not having a regular period.
“It’s important for girls and young women to recognize a hormonal imbalance and provide the proper treatments to protect the lining of the uterus from overgrowth from too much estrogen so that if they desire pregnancy, they will have that option.”
As she celebrates her first Mother’s Day with a child of her own, Simpson says: “Don’t give up. I never thought this day would come. She’s my miracle baby.”