Surgery for cervical cancer should be performed in a specialized center for oncology by a gynecologic oncologist or a gynecologist with a special interest in cancer.
The type of surgery will depend on the size of the cancer and whether it has spread beyond the cervix.
If the cancer cells have spread only slightly beyond the surface of the cervix, a cone-shaped section of the cervix is removed. This is called a cone biopsy.
An operation called a hysterectomy is often needed to treat cancer of the cervix.
- A total hysterectomy consists of removing the uterus and cervix and occasionally the fallopian tubes and ovaries.
A total hysterectomy is only appropriate for women whose cervical cancer is in an early stage (stage 1A1).
- A radical hysterectomy is when the uterus, the cervix, the tissue surrounding the cervix (parametrium), the fallopian tubes, the lymph nodes of the pelvis, the upper part of the vagina, and sometimes the ovaries are removed. Most cancer of the cervix are treated with a radical hysterectomy. Sometimes, some of the abdominal lymph nodes can also be removed from the lymph nodes of the pelvis.
To the extent possible, doctors try to avoid removing the ovaries of young women who have cervical cancer, as this procedure brings about early menopause.
A hysterectomy can be performed in many different ways. The most common way is through a cut (incision) in the abdomen. For some women, however, laparoscopic hysterectomy or minimally invasive surgery may be possible. During minimally invasive surgery, your doctor makes small incisions in your abdomen.
After undergoing a hysterectomy, you will no longer have a uterus, so you will not be able to get pregnant. If you need to have a hysterectomy you can ask a fertility specialist about what options are open for you.
For some women, it may be possible to perform an operation called a radical trachelectomy, where the uterus is left in place and the woman may still become pregnant. This type of operation is only appropriate for women with very early-stage cancer.
A radical trachelectomy involves removing the cervix, the tissues near the cervix, and the upper part of the vagina. The lymph nodes of the pelvis are also removed, generally by making small cuts in the abdomen.
There is a greater chance of miscarriage after this procedure, and if you do get pregnant the delivery will have to be through c-section