cervical cancer

Gynaecological cancers

Gynaecological cancer refers to the five types of cancers which start in a woman’s reproductive system. The following are the five types of gynaecological cancers:

  • Cervical cancer
  • Ovarian cancer
  • Vaginal cancer
  • Vulvar cancer
  • Womb cancer (also known as endometrial or uterine cancer)

So, for a better understanding, this article would highlight what cervical cancer is, in brief, the surgeries that are available as treatment and how those surgeries are performed.

What Is Cervical Cancer?

Cervical cancer occurs when there are changes in the cells, present in the woman’s cervix, that connect the uterus with the vagina. Cervical cancer affects the deeper tissues of the cervix and it might spread to other parts of the body (metastasize), often the liver, lungs, vagina, rectum and bladder. Maximum cases of cervical cancer are a result of an infection with human papillomavirus or HPV, which can be prevented with a vaccine. This cancer grows slowly, so there usually is time to find and treat it before it results in some critical problems. 

Cervical cancer kills fewer and fewer women each year and the credit goes to improved testing through Pap tests. Women who are about 35 to 44 years old are more likely to get cervical cancer. Approximately 15 percent of the new cases are in women who are above 65 years of age, especially the ones who haven’t been undergoing regular screenings.

Surgery to remove cervical cancer

There are different kinds of surgeries available to remove cervical cancer and they are as follows:

  1. hysterectomy
  2. trachelectomy
  3. cone biopsy

The type of operation that you would undergo, depends on several factors, such as:

  • the size of the cancer
  • the stage of the cancer
  • whether you have gone through menopause
  • whether you wish to have children in the future.

Whatever surgery you undergo, the sole motive is to remove the cancer. The surgeon would remove the cancer and a margin of healthy tissue that is surrounding it. Depending upon the kind of surgery you’re undergoing, the surgeons might even remove other tissues. After the completion of the surgery, the surgeon would send all the extracted tissues to the laboratory to examine them under the microscope.



1. Hysterectomy for cervical cancer


A hysterectomy is the name of a surgery that is performed to remove the womb. Hysterectomy is a standard surgery used as treatment for early-stage cervical cancer. If you have already gone through the menopause, the surgeon would even remove your ovaries and fallopian tubes. After this surgery, you would no longer be able to give birth to a child as the essential organs are removed. It might be extremely difficult for any woman to hear that her cancer surgery would mean that they can no longer get pregnant and give birth.

If your doctor recommends you to go for a hysterectomy, you can ask her or him to refer you to a fertility specialist before you undergo that surgery. They will surely be able to talk to you, regarding the available options for fertility. Female individuals who are interested in surrogacy, i.e. another woman carrying your child in her womb for you, might want to store eggs or fertilised eggs.



2. Trachelectomy


Trachelectomy is considered as a fertility-sparing surgery. It is an option for women who wish to have children in the future and its only for those who have early-stage cervical cancer. In this surgery, the surgeon would remove the upper part of your vagina and your cervix. They even generally remove the supporting tissues which surround your cervix. This is known as a radical trachelectomy.

The lymph nodes in your pelvis are even removed. The surgeon would do this by making small cuts in your abdomen. This is known as laparoscopic surgery. It might be done at the same time or a few days before the trachelectomy. The surgeon leaves your womb intact so that it is possible for you to have children in the future. The surgeon would generally apply a stitch at the bottom of the womb after the cervix is removed, which helps to keep the womb closed while the woman is pregnant.

There is a higher risk of miscarrying during pregnancy, after a trachelectomy. And fortunately, if you become pregnant, you would be referred to a local specialist maternity service so that you can be monitored closely. The delivery of your baby would be by caesarean section. Ask your surgeon as he or she would be able to explain more about this. Since trachelectomy is a very specialised surgery, it is not carried out in all the hospitals which treat cancer. 

If you feel to consider this surgery as an option, you would probably be referred to another hospital to discuss the possible risks and benefits with a surgeon who is specialised in this surgery.



3. Cone biopsy


A cone biopsy is a small surgery which is done to remove a cone-shaped piece of tissue from the cervix. This surgery is usually performed to cure the earliest stage of cervical cancer. This surgery is generally performed under general anaesthetic and you might need to stay overnight in the hospital. Afterwards, you would be provided with a small pack of gauze, like a tampon, in the vagina to prevent any minor or heavy bleeding. 

You would even have a tube to drain urine from the bladder with the gauze pack in its place. The tube and gauze pack are usually removed within twenty-four hours and then you would be allowed to go home.

How is the surgery done?

A trachelectomy or hysterectomy can be performed in different methods:

  • Laparoscopic surgery: In this surgery, the surgeon operates by making small cuts in your stomach. They usually make use of small surgical equipment and a thin telescope with a video camera on the end, known as a laparoscope. That small video camera lets the surgeon see inside your body.
  • Abdominal surgery: In this surgery, the surgeon makes only one cut or incision in the abdomen. Later on, you would have a wound which goes across your stomach close to the bikini line or it would go down from the belly button to the bikini line.
  • Robotic surgery: This surgery is similar to laparoscopic surgery, but the instruments and the laparoscope is attached to robotic arms. The operator would control the robotic arms, that can move and perform the surgery very delicately, precisely and steadily.
  • Vaginal surgery: In this surgery, the surgeon operates by making a cut at the top of the vagina. The surgeon might even combine this operation with laparoscopic surgery.

Your surgeon would let you know everything about the surgery you would undergo and would even discuss the benefits and risk factors before the surgery.





Tags: Cervical cancer surgery options, Cervical cancer treatment by stage, Cervical cancer symptoms