When a woman has surgery for cervical cancer, the doctor will try to remove the tumor and not leave any cancer cells behind. The surgeon is the most appropriate doctor to determine whether a tumor can be safely removed. Surgical treatment of cervical cancer depends on many things. Precancerous changes are treated differently than invasive cancer. Precancerous changes are also called dysplasia or carcinoma in situ. These types of changes are only in the surface layers of the cervix. They have not invaded deeper tissues. Invasive cancer has reached beyond the surface of the cervix.
Treatment for precancerous changes may depend on how severe the lesion is. If you have a low-grade lesion, you may need a very simple treatment such as cryotherapy, laser therapy, or conization. Hysterectomy is another option. However, there are very few reasons to perform this surgery for precancerous lesions. Here is a list of the most common types of surgery for precancerous changes.
Cryosurgery. This procedure freezes and kills the abnormal cells on the cervix. The surgeon places a thin piece of metal that has been cooled with liquid nitrogen against the cervix to cause frostbite. This freezing kills the abnormal cells on the cervix. This procedure is done in the doctor’s office. Anesthesia is usually not necessary.
Laser therapy. This type of surgery uses a narrow beam of light to create heat. The heat burns and destroys the lesions. You may have this procedure in your doctor’s office, usually without anesthesia.
Conization. This is considered a type of biopsy. Your doctor can do this simple procedure in his or her office while you’re under local anesthetic. The doctor uses a laser knife or an electric wire to remove a cone-shaped piece of tissue from the outer part of the cervix. A pathologist examines the cells under a microscope to make sure there is no cancer. When the electric wire is used, this procedure is also known as loop electrosurgical excision procedure (LEEP).
Simple hysterectomy. This is a major surgical procedure. A doctor removes the whole uterus through the abdomen or the vagina. This surgery requires regional anesthesia so you’re sedated or general anesthesia so you’re asleep. You stay at least overnight in the hospital. It is sometimes used for women who have had more than one treatment and no longer have enough tissue to perform a LEEP. Or you may have this procedure if you don’t plan to have children.
Invasive cancer means the cancer has spread beyond the surface of the cervix. Women with invasive cancer may be treated with some of the same surgical procedures used for precancerous lesions. The type used depends on the stage of the cancer as well as your desire to have children. Here is a list of the most common types of surgery for invasive cervical cancer and when doctors typically perform them. Before surgery, discuss your options carefully with your doctor.
Conization. This is a type of biopsy. Your doctor may use this procedure to treat a stage IA1 cancer if you want to have a baby later. He or she can do this simple procedure in the office under local anesthetic. The doctor uses a laser knife or an electric wire to remove a cone-shaped piece of tissue from the outer part of the cervix. A pathologist examines the cells under a microscope. In many cases, women are cured after one procedure. However, when using this treatment there is a small chance that the cancer will come back. So make sure to keep all follow-up appointments with your doctor. This is more common with adenocarcinomas. When the electric wire is used, this procedure is also known as loop electrosurgical excision procedure (LEEP).
Simple hysterectomy (vaginal or abdominal). This is the standard treatment for stage IA1 invasive cancers. A doctor removes your whole uterus through your abdomen or vagina. This surgery requires regional or general anesthesia. You are sedated or asleep. You stay at least one night in the hospital. Women get better faster when the hysterectomy is done through the vagina. However, vaginal hysterectomies may be hard to do in obese women or when other gynecologic disorders such as ovarian tumors are present. The ovaries and fallopian tubes do not need to be removed to cure cervical cancer. Discuss the removal of your ovaries and tubes with your surgeon before the operation.
Radical abdominal hysterectomy. This type of surgery is used to treat stage IA2, IB1, IB2, and IIA cancers. During surgery, a doctor removes your uterus, the upper part of your vagina, and the tissue that holds your uterus in place. The surgeon usually takes out the lymph nodes in the pelvic area as well. The doctor can remove all the structures through your abdomen. This surgery requires regional or general anesthesia. You are sedated or asleep. You spend several days in the hospital. It is not necessary to remove your ovaries in a radical hysterectomy. This is important for younger women. By keeping your ovaries, you will not enter menopause suddenly. Only a gynecologic oncologist should perform this type of surgery.
Radical trachelectomy. This procedure is uncommon and still under investigation. The doctor removes your cervix, pelvic lymph nodes, and upper part of your vagina. Doctors use this surgery for women with early cervical cancer who want to have children.
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