Treatment for Cervical Cancer — Page 2

Hysterectomy treatment for cervical cancer

A simple (total) hysterectomy removes your cervix and uterus. The surgery can be your best option for the early stage 0, stage I, and some stage II cervical cancers, if maintaining your ability to have a baby is not a factor in treatment — and if the cancer has not invaded your lymphatic system.

Depending on the stage of your cancer and whether it is beginning to spread, a radical hysterectomy, removal of nearby organs and tissues in addition to your 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. Your uterus is removed via a surgical incision in the front of your abdomen.
• Vaginal hysterectomy. Your uterus is removed through your vagina.
• Laparoscopic hysterectomy. Sometimes called keyhole surgery, this procedure removes your 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 your uterus, cervix, the upper part (about one inch) of your vagina next to the cervix, along with a wide area of ligaments and tissues around those organs. The ovaries, fallopian tubes, and lymph nodes located nearby may also be removed.
• Modified radical hysterectomy. This procedure also removes your uterus, cervix, and part of your vagina. Ligaments and tissues closely surrounding those organs are removed, too. Lymph nodes nearby may also be removed. Not as many tissues or organs are surgically removed compared to a radical hysterectomy.
• Radical trachelectomy. Although your cervix, nearby tissue, and lymph nodes and the upper part of your vagina are removed surgically, the uterus and ovaries are spared in this procedure, which may be performed through your vagina or abdomen. After your cervix is removed, the uterus is attached to the remaining part of your vagina. The surgeon then uses a "purse-string" stitch or band inside your 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 treatment (although their babies must be delivered by cesarean section). Women who have had radical trachelectomy surgery may be at an increased risk of miscarriage.
• 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 addition, depending on where the cancer has spread, your lower colon, rectum, and bladder may be removed. The surgeon creates stomas, artificial openings that allow urine and stool to move through your body to collection bags. An artificial vagina may also be created using plastic surgery techniques.

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