Surgery for cervical cancer

Surgery is used to treat early-stage cervical cancer. The type of surgery you have will depend on the size of your cancer and whether it has spread.

A cone biopsy is an operation to remove a piece of tissue from the cervix. This surgery is done if the cancer cells have only spread slightly beyond the surface of the cervix.

A hysterectomy is an operation to remove the womb (uterus). There are two types of hysterectomy that may be carried out:

  • A total hysterectomy
  • A radical hysterectomy.

A hysterectomy may be carried out through a cut in you tummy or by keyhole surgery.

If you would still like to have children, your doctor may recommend a radical trachelectomy. This operation is only suitable if you have very early stage cervical cancer. In this operation, the womb is left in place so it may still be possible for you to have a baby. This type of surgery is only done in a few hospitals in the UK.

Types of surgery

There are three different types of surgery used to treat early stage cervical cancer:

  • cone biopsy
  • hysterectomy
  • radical trachelectomy.

The type of surgery you have will depend on the size of your cancer and whether it has spread beyond the cervix.


Cone biopsy

If the cancer cells have spread only slightly beyond the surface of the cervix, it may be possible to treat it by removing a cone-shaped piece of tissue from the cervix.


Hysterectomy

A hysterectomy is an operation to remove the womb (uterus). There are two types that may be carried out to treat cervical cancer. The type you have will depend on the stage of your cancer:

Total hysterectomy

A surgeon will take out your womb and cervix. They sometimes remove your pelvic lymph nodes as well. If you have had your menopause your fallopian tubes and ovaries will also be removed. Occasionally you will have these removed even if you haven’t had your menopause. This operation is only suitable if you have very early stage cervical cancer (stage 1A1 1A2).

Radical hysterectomy

The surgeon will take out your womb, cervix, tissue around the cervix (parametrium), fallopian tubes, pelvic lymph nodes and upper part of the vagina. Sometimes they’ll take out the ovaries and abdominal lymph nodes as well.

Where possible, the ovaries are not taken out in young women with cancer of the cervix. This is because removal of the ovaries brings on an early menopause. We have more information about early menopause and ways to help you manage menopausal symptoms.

A hysterectomy can be carried out in different ways:

Abdominal hysterectomy

You will normally have this operation under a general anaesthetic. Your surgeon will cut across your tummy (abdomen), just above the pubic hair. Sometimes, they may cut downwards from the belly button to the pubic hair.

Laparoscopic hysterectomy (also called keyhole surgery)

You will usually have this operation under a general anaesthetic. Your surgeon will make several small cuts in your tummy. They’ll put small surgical instruments and a laparoscope (a telescope with a camera on the end) through the cuts. The womb, cervix and ovaries (if needed) are then removed through your vagina or a small cut in your tummy.

We have more information about the different types of hysterectomy.

After a hysterectomy you will no longer have a womb, so if you’re of child-bearing age you will be unable to become pregnant. Being told that your cancer treatment will mean you can no longer have children can be very difficult. If you’re told you need to have a hysterectomy, you can ask your hospital doctor to refer you to a fertility specialist before your surgery to discuss possible options.

We have more information about fertility and cervical cancer.


Radical trachelectomy

This operation is only suitable if you have very early-stage cancer of the cervix.

If you would still like to be able to have children, you may be able to have an operation called a radical trachelectomy. In this operation, the womb (uterus) is left in place so you can still have a baby.

Your surgeon will remove the cervix, the tissues next to the cervix and the upper part of the vagina. They will also remove the lymph nodes in the pelvis, usually through tiny cuts in your tummy (called keyhole or laparoscopic surgery). They will leave the womb in place and put a stitch at the bottom of it during the surgery. This helps to keep the womb closed during pregnancy.

There is a higher chance of miscarriage after this procedure, and if you become pregnant the baby would need to be delivered by caesarean section.

This type of surgery is only done in a few hospitals in the UK. You may need to ask your surgeon to refer you to a specialist hospital if you would like to discuss the possibility of having a radical trachelectomy. It’s important your surgeon fully explains to you the benefits and possible risks of this type of operation.

Back to Surgery explained

What happens after surgery?

You’ll be monitored very closely after your operation. You will be very tired so it’s important to rest and look after yourself.

Follow-up care after surgery

After surgery you have an appointment with your surgeon to check on your recovery and discuss the results of your operation.