Cervical Cancer

Surgery

Surgery to remove cervical cancer may be an option when the cancer is confined to the cervix or uterus. The type of surgery performed depends on the location and extent of cervical cancer and your desire to be able to have children.

Surgery Choices

Surgery for very early stages of cervical cancer that preserves your ability to have children includes:

• A cone biopsy or loop electrosurgical excision procedure (LEEP), which removes a wedge of cervical tissue that contains the cancer.
• Radical trachelectomy and laparoscopy for pelvic lymph node dissection, which removes the cervix and area lymph nodes, but not the uterus. Radical trachelectomy is not commonly used.

Surgery for most stages of cervical cancer does not preserve your ability to have children. Surgeries include:

• Hysterectomy with or without removal of the ovaries, to remove the cervix and related organs where recurrence would be most likely to occur.
• Modified radical hysterectomy with pelvic lymph node dissection. A radical hysterectomy usually includes removal of part of the vagina, the uterus, the ovaries, and the fallopian tubes. This removes the most likely sites of cancer and may reduce the risk of recurrence.

What To Think About

If surgery is part of your treatment, you also may be given radiation therapy, chemotherapy, or combination chemoradiation. These treatments may be given before or after surgery to try to destroy any cancer cells that may remain. Radiation, chemotherapy, or chemoradiation given before a surgery to help control or reduce the size of the tumor is called neoadjuvant therapy. Using these therapies after a surgery when only microscopic areas of cancer may still be present is called adjuvant therapy.

Compared with radiation alone, chemoradiation improves survival if it is used either before or after a hysterectomy.⁹

Side effects from surgery can include difficulty with urination or problems with bowel habits, such as constipation or diarrhea. Your ability to have or enjoy sexual intercourse may also be affected.

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Author:	Bets Davis, MFA	Last Updated: September 5, 2008
Medical Review:	Anne C. Poinier, MD - Internal Medicine Kevin Holcomb, MD - Gynecologic Oncology
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