Surgery for cervical cancer
For some women, surgery may be the only treatment needed. Surgery is usually recommended for women who have a tumour that is in the cervix only. The type of surgery you have will depend on how far within the cervix the cancer has spread. Your surgeon will talk to you about the most appropriate surgery for you, as well as the risks and any possible complications (in both the short and long term).
The main type of surgery is called a hysterectomy, which is done under general anaesthetic. A hysterectomy is an operation to remove the uterus (womb) and cervix. The surgeon may also remove other organs of the reproductive system or the lymph glands on the side wall of the pelvis.
Learn more about:
- Types of surgery
- How the surgery is done
- Treatment of lymph nodes
- What to expect after surgery
- Side effects of surgery
- Taking care of yourself at home
- Video: What is 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 biopsyRemoves a cone of tissue around the cancer, including a margin of healthy tissue. This is used to treat very early cervical cancers, particularly for young women who would like to have children. Learn more about the procedure.
TrachelectomyRemoves 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 in young women with early-stage cancer who would like to have children.
Total hysterectomyRemoves the uterus and cervix. Can be suitable for early cervical cancers. The fallopian tubes are also commonly removed (see Bilateral salpingectomy). Some premenopausal women are able to keep their ovaries.
Radical hysterectomyRemoves 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. Some premenopausal women are able to keep their ovaries.
Bilateral salpingectomyRemoves both fallopian tubes. This is commonly recommended for women having a hysterectomy performed through the abdomen (open surgery). Your doctor will talk to you about the risks and benefits of removing the fallopian tubes.
Bilateral salpingo-oophorectomyRemoves both fallopian tubes and ovaries. This is considered when your doctor is concerned that the cancer may have spread to the ovaries, or for women approaching the menopause or of menopausal age.
How the surgery is done
The surgery will be performed under a general anaesthetic. The hysterectomy can be done in two different ways.
Open surgery (laparotomy)
The surgery is performed through the abdomen. A cut is usually made from the pubic area to the bellybutton. Sometimes the cut is made along the pubic line instead. The uterus and other organs are then removed. Research has shown that open surgery is the better option for most cervical cancers.
Keyhole surgery (laparoscopy or robotic surgery)
These methods use thin cameras and instruments that are inserted through small cuts into the abdomen. The uterus and other organs are removed through the vagina. Laparoscopic surgery may be used for small, early-stage tumours.
Treatment of lymph nodes
Cancer cells can spread from the cervix to the lymph nodes in the pelvis. You may have one of the following procedures:
Sentinel lymph node biopsy
This test helps to identify the lymph node that the cancer is most likely to spread to first (the sentinel lymph node). While you are under anaesthetic, your doctor 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 remaining nodes in the area may be removed in a procedure called a lymphadenectomy. Alternatively, your doctors may decide you need other treatments such as chemoradiation. A sentinel lymph node biopsy can help the doctor avoid removing more lymph nodes than necessary and minimise side effects such as lymphoedema. This procedure may be used for some women with early cervical cancer and is only available in some treatment centres. Research into its role in treating cervical cancer is ongoing.
Lymphadenectomy (lymph node dissection)
The surgeon will remove an area of lymph nodes from the pelvic and/or abdominal areas to see if the cancer has spread beyond the cervix. If cancer is found in the lymph nodes, your doctor may recommend you have additional treatment, such as radiation therapy.
Video: What is surgery?
A/Prof Penny Blomfield, Gynaecological Oncologist, Hobart Women’s Specialists, and Chair, Australian Society of Gynaecological Oncologists, TAS; Karina Campbell, Consumer; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Dr Pearly Khaw, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; A/Prof Jim Nicklin, Director, Gynaecological Oncology, Royal Brisbane and Women’s Hospital, and Associate Professor Gynaecologic Oncology, The University of Queensland; Prof Martin K Oehler, Director, Gynaecological Oncology, Royal Adelaide Hospital, SA; Dr Megan Smith, Program Manager – Cervix, Cancer Council NSW; Pauline Tanner, Cancer Nurse Coordinator – Gynaecology, WA Cancer & Palliative Care Network, WA; Tamara Wraith, Senior Clinician, Physiotherapy Department, The Royal Women’s Hospital, VIC. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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Surgery is a medical treatment performed by a surgeon or a surgical oncologist to remove cancer from the body or repair a part of the body affected by cancer
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