Surgery for cervical cancer

For some people, surgery may be the only treatment needed.

Learn more about:

• Overview
• Types of surgery
• How the surgery is done
• Surgery to remove lymph nodes
• What to expect after surgery
• Side effects of surgery
• Taking care of yourself at home

Overview

Surgery is usually recommended when the tumour is in the cervix only. The type of surgery you have will depend on how far within the cervix the cancer has spread. The illustrations below provide more information about the main types of surgery used. Your gynaecological oncologist may also remove some lymph nodes during surgery.

For more on this, see our general section on Surgery.

Types of surgery

Depending on how far the cancer has spread and your age, you may have one or more of the procedures listed below.

	Cone biopsy Removes a cone-shaped piece of tissue around the cancer, including a margin of healthy tissue. A cone biopsy is used to treat very early cervical cancers. You may have this if you would like to have children. For more information see cone biopsy.
	Trachelectomy Removes part or all of the cervix, along with the upper part of the vagina. The uterus, fallopian tubes and ovaries are left in place. This is not a common procedure, but it may be used if you have early-stage cancer and would like to have children. For more information see Fertility issues.
	Total hysterectomy Removes the uterus and cervix. This surgery can be used for early cervical cancers. The fallopian tubes are also commonly removed (see Bilateral salpingectomy). You may be able to keep your ovaries if you are premenopausal.
	Radical hysterectomy Removes the uterus, cervix, and soft tissue around the cervix and top of the vagina. This is the standard operation for most cervical cancers treated with surgery. The fallopian tubes are also commonly removed (see Bilateral salpingectomy). You may be able to keep your ovaries if you are premenopausal.
	Bilateral salpingectomy Removes both fallopian tubes. A bilateral salpingectomy may be recommended if you are having a total or radical hysterectomy.
	Bilateral salpingo-oophorectomy Removes both fallopian tubes and ovaries. This may be considered for those who are having a hysterectomy when there is a risk that the cancer may have spread to the ovaries, which may happen with adenocarcinoma. This procedure may be recommended before or after menopause.

Surgery to remove lymph nodes

You may have one of the following procedures to check if the cancer has spread from the cervix to lymph nodes in the pelvis. If cancer is found in the lymph nodes, your doctors may recommend additional treatment.

Lymphadenectomy (lymph node dissection)

The surgeon will remove a number of lymph nodes from the pelvic and/or abdominal areas to see if the cancer has spread beyond the cervix.

Sentinel lymph node biopsy

This procedure may be used for early cervical cancer but is only performed in some treatment centres. It helps to find the lymph node that the cancer is most likely to spread to first (the sentinel lymph node). While you are under anaesthetic, your surgeon will inject a dye into the cervix. The dye will flow to the sentinel lymph node and the surgeon will remove it for testing. If it contains cancer cells, the surgeon may remove the remaining nodes in the area (lymphadenectomy, see above). Alternatively, your doctors may decide you need other treatments such as chemoradiation. A sentinel lymph node biopsy can help avoid the removal of more lymph nodes than necessary and minimise side effects such as lymphoedema.

→ READ MORE: What to expect after surgery

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