Surgery is the most common treatment for early cervical cancer, although radiation can also be used and typically works equally as well. Several types of surgery can be performed, but the final choice for you will depend on several factors that your oncologist will consider, especially the stage and size of your cancer as well as your general health.
- Cervical conization: Conization means surgical removal of just the cancerous (or precancerous in many cases) part of the cervix. Conization is an option only for the earliest cancers, the ones that are microscopic. This is the preferred treatment for women with very small cancers who wish to preserve fertility.
- Vaginal or abdominal hysterectomy: In a vaginal hysterectomy, the uterus and cervix are removed through the vagina. In an abdominal hysterectomy, these organs are removed through an incision on the abdomen.
- Laparoscopic hysterectomy: This involves the removal of the uterus and cervix in a procedure that is performed through several (3-5) very small incisions on your abdomen and the uterus and cervix are brought out through the vagina. This procedure allows for quicker recovery than abdominal hysterectomy.
- Robotic hysterectomy: This procedure is essentially the same as a laparoscopic hysterectomy using several small incisions, but in this procedure your surgeon uses the assistance of a robotic technology (robot) which s/he is in control of at all times to perform your surgery.
- Radical abdominal hysterectomy: This procedure may be performed through an abdominal incision, but sometimes it can be recommended to be performed through small incisions either laparoscopically or with the assistance of robotic technology. The word radical means that the uterus and the tissue between the uterus and pelvic wall, as well as part of the upper vagina, are removed. Lymph nodes in the pelvis are also removed and examined to determine if the cancer has spread (radical pelvic lymphadenectomy). In some cases, both ovaries and both fallopian tubes must be removed. This procedure is called a bilateral salpingo-oophorectomy.
- Radical trachelectomy: This is a surgery where your cervix and surrounding tissues are removed but the upper uterus is preserved for future pregnancy. This operation is only available for carefully selected women.
Side effects of surgery
Some pain and discomfort are common after surgery. Pain can be controlled with medicine. Tell your treatment team if you are experiencing more than mild pain.
Other early side effects (days to weeks after surgery):
- Discomfort related to tubes, catheters and medical devices
- Difficulty urinating so that a catheter that may stay in your bladder for a few days to weeks is often necessary
- Soreness of the abdomen around the incision
- Cramps and gas pains
- Watery vaginal discharge or bleeding
Later side effects (weeks to months):
- Difficulty urinating
- Shortening of the vagina
Some things may be done at the time of your surgery to minimize these side effects (such as placement of a temporary drainage catheter in your bladder). Women who have a hysterectomy will stop having periods and will no longer be able to have children. Hormone levels will be the same if the ovaries are left in or may fall to menopausal levels if the ovaries are removed. Hormone therapy to treat menopausal symptoms is usually an option if the ovaries are removed.