Cervical Cancer - Treatment for Cervical Cancer

Laser surgery for cervical cancer uses a laser beam, in place of a knife, to burn off abnormal cells or to remove pieces tissue for biopsy. The laser beam is directed through the vagina.

Conization

Conization is a surgical procedure that removes a cone-shaped piece of tissue from the cervix. Conization uses either a heated wire, like LEEP, or it may involve a scalpel or laser (in which case the procedure is sometimes called “cone knife cone biopsy”). The surgery is performed under general anesthesia in an operating room. With conization, the ability to become pregnant can be preserved in most cases.

Hysterectomy

A hysterectomy attempts to eliminate the cancerous tissue by removing the uterus. In women of childbearing age, the ovaries can usually be left intact. Although a woman who has a hysterectomy but retains her ovaries cannot bear children, she will not go into premature menopause.

Women with cervical cancer usually have either a total (simple) hysterectomy or a radical hysterectomy.

Total Hysterectomy. A total (also called simple) hysterectomy involves the removal of the uterus and the cervix, but leaves the parametrium (tissue surrounding the uterus) and vagina intact. Lymph nodes in the pelvis are not usually removed. The uterus may be removed through an open abdominal incision or vaginally. There are various ways to perform vaginal hysterectomy, including laparoscopically. A simple hysterectomy is usually performed to treat stage IA1 cervical cancer. [For more information on hysterectomy procedures, see In-Depth Report #73: Uterine fibroids and hysterectomy.]

Hysterectomy - series Click the icon to see an illustrated series detailing a hysterectomy.

Radical Hysterectomy. A radical hysterectomy removes not only the uterus and the cervix but also the parametrium, the supporting ligaments, the upper vagina, and some or all of the pelvic lymph nodes (a procedure called lymphadenectomy). The fallopian tubes and ovaries are not usually removed, (a procedure called bilateral-salpingo-oopherectomy) unless there are other medical reasons for doing so. Radical hysterectomy is used to treat cervical cancers in stages IA2, IB1, and IB2.

Pelvic Exenteration. If the cancerous tumor recurs within the pelvis after primary treatment, the patient may need a more extreme procedure called a pelvic exenteration, which combines radical hysterectomy with removal of the bladder and rectum. (In such cases, plastic surgery may be needed afterward to recreate an artificial vagina.)


Review Date: 10/21/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)