Before and after surgery for cervical cancer
Information about what happens before surgery for cervical cancer, and what to expect afterwards.
If you smoke, try to give up or cut down before your operation. This will help reduce your risk of chest problems and will help your wound to heal after the operation. Your GP can help you if you want to give up smoking.
If you are having a hysterectomy or trachelectomy, you will go to a pre-assessment clinic a few days or weeks before the operation. You will have tests to check you are fit for surgery, such as blood tests and an echocardiogram (ECG) to check your heart.
A member of the surgical team and a specialist nurse will explain the operation to you. Make sure you discuss any questions or concerns you have about the operation with them. You will also see the doctor who will give you your anaesthetic (the anaesthetist). They will talk to you about the anaesthetic and explain how your pain will be controlled after the operation.
You will usually be admitted to hospital on the morning of your operation. You will be given elastic stockings (TED stockings) to wear during and after the operation. These prevent blood clots forming in your legs.
How quickly you recover will depend on the type of operation you have and if you had abdominal or laparoscopic surgery.
You will be encouraged to start moving around as soon as possible. While you are in bed, it is important to move your legs regularly and do deep breathing exercises. This is to help prevent chest infections and blood clots. A physiotherapist will show you how to do these exercises. You will also have daily injections of a blood thinning drug to reduce the risk of blood clots. If you have had lymph nodes removed from your groin, you will be encouraged to put your feet up when you are sitting. This helps to reduce leg swelling.
Drips and drains
You will be given fluids into a vein in your hand or arm. This is called a drip or an intravenous (IV) infusion. This will be taken out as soon as you are eating and drinking normally.
You may have a drainage tube in your wound or tummy (abdomen) to drain excess fluid into a small bottle. The drain is usually removed after a few days.
You will have a tube (catheter) to drain urine from your bladder. It is usually taken out a few days after your surgery. Sometimes after a radical hysterectomy or trachelectomy, some women have difficulty passing urine once their catheter has been removed. This is temporary. If it happens, a catheter is put into the bladder for 2 to 3 weeks until the bladder recovers.
It is normal to have some pain or discomfort for a few days after surgery. But this can be controlled with painkillers. It is important to let your doctor or nurse know as soon as possible if the pain is not controlled, so that they can change your painkillers.
Immediately after your operation you may have strong painkillers. You may be given painkillers through one of the following straight after your operation:
By injection into a muscle
The nurses will do this for you.
This is a small, thin tube in your back that goes into the space around your spinal cord. An epidural will give you continuous pain relief.
A patient-controlled analgesia pump (PCA pump)
The pump is attached to a fine tube (cannula), in a vein in your arm. You control the pump using a handset that you press when you need more of the painkiller. It is fine to press the handset whenever you have pain. The pump is designed so that you cannot give yourself too much painkiller
When you no longer need strong painkillers, you will be given milder painkillers as tablets. You may be given a supply to take home. Tell your nurse or doctor if you are still in pain, so they can adjust the dose or give you a different painkiller.
The surgeon will close your wound using clips, stitches or sometimes skin glue. Clips or stitches are usually removed after you go home. A practice nurse at your GP surgery can do this. Some stitches, called dissolving stitches, can be absorbed by the body and do not need to be removed.
Wound infections can be a complication of the surgery. Signs of wound infection include:
- discharge (fluid or pus coming from the wound)
- feeling unwell
- a fever or high temperature.
Tell your nurse or doctor if you get any of these symptoms, even after you go home. If you can’t talk to your hospital team, tell your GP or out of hours service.
If you are having problems opening your bowels after surgery, tell your doctor or nurse. They can give you a laxative to help your bowels move. See your GP if you have problems after being discharged from hospital.
Many women experience low mood about three days after surgery. This may last for 24 to 48 hours. It is a normal reaction to a stressful event such as surgery after being diagnosed with cancer. Your nurse specialist will be able to support you.
Before you go home, you will be given an appointment to attend an outpatient clinic to get the results of the operation and for your post-operative check-up.
A nurse will give you instructions on how to look after yourself as you recover.
If you need to go home with a urinary catheter, the hospital team can arrange for a district nurse to visit you at home to check how things are.
If you have any concerns, talk to the nurse about these. It is important that you follow the advice you are given.
Blood thinning injections
It is important to continue with daily blood thinning injections for four weeks after the operation. You will be given a supply of injections to take home. A nurse will show you how to inject yourself. If you are not able to inject yourself, they will show a relative or friend how to do this or arrange for a district nurse to do it for you.
After a hysterectomy or trachelectomy, you may have a vaginal discharge for up to six weeks. This is usually reddish-brown in colour. Contact your doctor straight away if the discharge:
- becomes bright red
- is heavy
- smells unpleasant
- contains clots.
Your doctor or nurse will advise you to have a shower daily. They will also advise you not to have sex or place anything in your vagina (such as tampons) for about six weeks after your surgery. You should also avoid swimming. This is so the surgical area can heal properly and to reduce the risk of infection.
Your surgeon will usually advise you not to have sex for at least six weeks after your operation. This is to give your wound time to heal properly. After that, you will be able to get back to your usual sex life. But it is not unusual to need more time before you feel ready, especially if you are having other treatments as well.
It is important to avoid strenuous physical activity for several weeks after your operation. This is usually for about 6 weeks after laparoscopic surgery and for about 12 weeks after abdominal surgery. You will need to avoid strenuous activities, such as:
- activities that make you breathless
- anything that involves heavy lifting, pushing, pulling or stretching.
Your physiotherapist or nurse will be able to give you advice about physical activity.
Some women find it uncomfortable to drive for a few weeks after their surgery. Ask your nurse or doctor for advice on when it will be safe for you to start driving again. Some insurance companies have guidelines about this. You may want to contact your insurer to check you are covered to drive.
Some women take longer than others to recover from their operation. If you are having problems, it may be helpful to talk to someone.
Your clinical nurse specialist or our cancer support specialists (0808 808 00 00) are always happy to talk to you. They may be able to put you in touch with a counsellor or a support group in your area, so you can discuss your experiences with other women who are in a similar situation.
You can also go to our Online Community to share experiences and information with other women going through the same thing.
Some women may have bladder, bowel or sexual problems after a radical hysterectomy or radical trachelectomy. This can happen if nerves that control the bladder, bowel or sexual response are damaged during the operation. Your surgeon may use nerve-sparing or nerve-preserving surgery to reduce the risk of these complications.
If your lymph nodes have been removed, there is a risk you will develop swelling in one or both legs. This is called lymphoedema. It is caused by a build-up of lymph fluid that cannot drain away because the lymph nodes have been removed. It is more likely to happen if you have radiotherapy or chemoradiation to the pelvic area after surgery.
If you develop any problems after your surgery, tell your surgeon or nurse so that you can get the right kind of help.
Most women will not have long-term complications after surgery for cervical cancer. However, if you have radiotherapy or chemoradiation as well as surgery, you are more likely to develop long-term complications.
Below is a sample of the sources used in our cervical cancer information. If you would like more information about the sources we use, please contact us at email@example.com
Marth C, et al. on behalf of the ESMO Guidelines Committee. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2017. 28(s4): iv72-iv83. Available at www.annalsofoncology.org/article/S0923-7534(19)42148-0/pdf
National Institute for Health and Care Excellence (NICE). Menopause. Quality standard (QS143). 2017. Available at www.nice.org.uk/guidance/qs143
Farthing AJ and Ghaem-Maghami S on behalf of the Rotal Collage of Obstetricians and Gynaecologists (RCOG). Fertility Sparing Treatments in Gynaecological Cancers. 2013. Available at www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_35.pdf
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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