If you have cervical cancer, there are a number of ways your doctor can treat your condition. Which one they recommend will depend on what type of cervical cancer you have, your age, and whether or not you might want to have children in the future.
It will also depend on whether, or how far, the cancer has spread. Doctors call this the “stage” of the cancer. Surgery is just one option to discuss with your doctor.
Conization
Your doctor may do this before they recommend chemotherapy or radiation. If you want to be able to have kids later, it may be the only treatment they recommend.
Your doctor uses a surgical or laser knife to remove a cone-shaped piece of tissue from your cervix. They may also use a thin wire heated by electricity. This is called the loop electrosurgical excision procedure, or LEEP. They’ll look at your tissue sample under a microscope. If the edges of the cone have cancer cells, some of the cancer may have been left behind. You will need another conization or a hysterectomy (removal of the uterus and cervix). Your doctor may recommend chemo or radiation.
Hysterectomy
In this procedure, a surgeon removes your uterus and cervix. Your other reproductive organs -- your ovaries and fallopian tubes -- are left in place, unless there’s a medical reason they should be removed, too.
Surgeons perform hysterectomies in one of three ways: through a cut in the abdomen (abdominal hysterectomy); through the vagina (vaginal hysterectomy); through conventional laparoscopy, or with the help of robotic instruments (laparoscopic hysterectomy).
You’ll have to stay in the hospital after your surgery. With a laparoscopic or vaginal hysterectomy, you’ll have a 1- or 2-day stay, or it may be performed in the doctor's office or clinic. Full recovery time is about 2 to 3 weeks.
After an abdominal hysterectomy, you’ll stay in the hospital for 3 to 5 days. Recovery time is longer -- about 4 to 6 weeks.
Complications are rare, but can include excessive bleeding, infection, or damage to your urinary system or intestines.
Radical Hysterectomy
During this surgery, the surgeon removes your uterus and the tissues next to it. They’ll also remove about 1 inch of the vagina next to your cervix. And, they may take some of the lymph nodes from your pelvic area. These are pockets of immune system tissue that are about the size of a pea.
Your doctor will leave your ovaries and fallopian tubes, unless it’s medically necessary to take them, too.
Most of the time, this surgery is performed through your abdomen. But your doctor may be able to use laparoscopy to remove your uterus through your vagina. This results in less blood loss, and maybe a shorter hospital stay.
Full recovery time is 4 to 6 weeks. Call your doctor right away if you have excessive bleeding, trouble peeing, or believe your wound is infected.
Trachelectomy
If you still want to be able to have kids, your doctor may recommend a trachelectomy.
The surgeon removes your cervix and the top part of your vagina, but they leave your uterus intact. They place a stitch, or a band, where your cervix had been. This opening leads to your uterus.
They may also remove the lymph nodes near your cervix or uterus. They’ll perform this surgery either through your vagina or through a cut in your abdomen.
The chance of your cancer coming back after this operation is very low. Studies show that women who have a trachelectomy have a 50% chance of getting pregnant 5 years later. But they also are at a higher risk of miscarriage than women who haven’t had this surgery.
Pelvic Exenteration
If you’ve had cervical cancer that came back or spread (metastasized), your doctor may suggest this as a surgical option. They’ll remove your cervix, uterus, and surrounding organs and tissues. They’ll also remove nearby lymph nodes. And, depending on where the cancer has spread, they may take your bladder, vagina, rectum, and part of your colon.
If your doctor has to remove part of your bladder or colon, they’ll have to create a new way for you to remove waste. You may have to have a catheter. Or, they’ll attach a plastic bag to the front of your abdomen to catch urine, called a urostomy, or feces, called a colostomy.
Your doctor can also create a new vagina from your skin, tissue from your intestines, or muscle or skin grafts.
Recovery from pelvic exenteration can take 6 months or more.