Hysterectomy treatment for cervical cancer
A simple (total) hysterectomy removes the entire cervix and uterus. This can be the best option for the early stage 0, stage I, and some stage II cervical cancers, if maintaining the ability to have a baby is not a factor in treatment — and if the cancer has not invaded the lymphatic system.
However, depending on the stage of cervical cancer and whether it is beginning to spread, a radical hysterectomy, which removes nearby organs and tissues in addition to the cervix and uterus, may be the best surgical treatment.
A hysterectomy and related surgical procedures for cervical cancer can be performed in several ways:
- Abdominal hysterectomy. The uterus is removed via a surgical incision in the front of the abdomen.
- Vaginal hysterectomy: The uterus is removed through the vagina.
- Laparoscopic hysterectomy: Sometimes called “keyhole surgery,” this procedure removes the uterus using laparoscopy (a thin tube with a tiny video camera at the end) and instruments controlled through the tube. This allows the surgeon to make cuts and remove tissue through small surgical incisions instead of a large abdominal cut.
- Radical hysterectomy: This surgery removes the uterus, cervix, the upper part (about one inch) of the vagina next to the cervix, and a wide area of ligaments and tissues around these organs. The ovaries, fallopian tubes, and lymph nodes located nearby may also be removed.
- Modified radical hysterectomy: This procedure also removes the uterus, cervix, and part of the vagina. Ligaments and tissues closely surrounding these organs are removed, too. Lymph nodes nearby may also be removed. However, not as many tissues or organs are surgically removed compared to a radical hysterectomy.
- Radical trachelectomy: Although the cervix, nearby tissue, and lymph nodes and the upper part of the vagina are removed surgically, the uterus and ovaries are spared in this procedure, which may be performed through the vagina or abdomen. After the cervix is removed, the uterus is attached to the remaining part of the vagina, and the surgeon uses a "purse-string" stitch or band inside the uterine cavity to act as the cervix. The stitch may be opened or closed as needed and can allow some women to have successful pregnancies after this treatment for cervical cancer (although their babies must be delivered by cesarean section). Women who have had this surgery may be at an increased risk of miscarriage, however.
- Pelvic exenteration: This extensive surgery may be used as part of treatment for cervical cancer that recurs. The same organs and tissues removed in a radical hysterectomy, along with lymph nodes, are taken out in this operation. In addition, depending on where the cancer has spread, the lower colon, rectum, and bladder may be removed, too. The surgeon creates stoma, artificial openings, which allow urine and stool to move through the body to collection bags. An artificial vagina may also be created using plastic surgery techniques.
March 18, 2020
Janet O’Dell, RN