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Trachelectomy for cervical cancer

A  trachelectomy is a type of surgery that removes the cervix. It is used for early stage cervical cancer. 

We know that reading about surgery can be overwhelming, whether you are making treatment decisions, waiting to have it, or recovering. We are here to support you – that might be by talking through options, helping you understand more about trachelectomy, or simply listen to what’s going on.

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What is a trachelectomy?

A trachelectomy is a surgery for early stage cervical cancer that removes the cervix. It is pronounced track-uh-leck-tom-me. 

Trachelectomy is sometimes called a fertility sparing surgery. This is because it does not remove the womb (uterus), meaning it may be possible to become pregnant in the future. 

Research has shown that trachelectomy is just as effective at removing cervical cancer as another type of surgery called hysterectomy. 

Types of trachelectomy

There are different types of trachelectomy:

A radical trachelectomy removes:

  • the cervix
  • the tissue around the womb (parametrium) 
  • part of the upper vagina.

A simple trachelectomy only removes the cervix. It does not remove the tissue around your womb, called the parametrium, or part of the upper vagina. 

Sometimes the lymph nodes in your pelvis are also removed during trachelectomy. Removing the lymph nodes is called a lymphadenectomy.  

Read about lymph node removal >

Who can have a trachelectomy?

Trachelectomy is an effective treatment for  early stage cervical cancer. It is usually suggested for cervical cancers that measure 2cm or less.  This normally means stages 1A1, 1A2 or 1B1, as long as the cervical cancer has not spread to your lymph nodes.      

Read about staging and grading cervical cancer >

A trachelectomy is not available in all hospitals. You may need to be referred to another hospital that has a surgeon who specialises in this surgery.  

Tests before trachelectomy

Before your healthcare team recommend a trachelectomy, you may have some tests to measure how long your cervix is. This is to make sure it will be an effective treatment for you and, if fertility is important to you, that they can try to preserve it.  

You might have:

  • colposcopy
  • hysteroscopy 
  • cone biopsy.

Read about tests for cervical cancer >

Making decisions about treatment

A team of healthcare professionals, called a multidisciplinary team or MDT, will discuss your test results, diagnosis and medical history to help decide which treatments are best for you.

It is important that you are involved in any decisions about your treatment. You need to know and understand all the information about the treatment, including the benefits and risks. 

You may also want to think about how having the treatment might impact on your life, including:

  • being able to have a child or more children (fertility)
  • being able to keep working (employment)
  • your finances, for any support you might need
  • other commitments or responsibilities you have. 

Read about making treatment decisions >

Your healthcare team should talk to you about how a trachelectomy can impact fertility and your chances of getting pregnant after the surgery. They should respect your decisions about treatment and offer you further support, such as talking to your clinical nurse specialist (CNS) or a counsellor to help you make a choice.  

During a trachelectomy, your womb is not removed and a stitch is put in place of your cervix. If you get pregnant in future, this stitch aims to reduce the risk of having a miscarriage or a baby born early (prematurely). The baby would be born by caesarean section (C-section) to make sure your cervix is not damaged and avoid heavy bleeding.   

If you do get pregnant there may still be a higher risk of miscarriage and of the baby being born prematurely. 

Understanding the risk

After a trachelectomy, the risk of having a miscarriage in the first 12 weeks of pregnancy is about 16 in 100 (16%). This is similar to the risk of 15 to 20 in 100 (15% to 20%) in those who have not had treatment. 

After a trachelectomy, the risk of having a miscarriage in months 3 to 6 of pregnancy is 7 out of 100 (7%). This is higher than the risk of 1 to 2 out of 100 (1% to 2%) of those who have not had treatment. Most miscarriages in the second trimester are caused by infection.  

Read more about fertility after cervical cancer treatment >

Getting support

Fertility can be very difficult to think about, especially when you are already coping with a cervical cancer diagnosis and treatment. It may help to know that if you do get pregnant, you should be referred to a local specialist maternity service for closer monitoring.   

Read about having a safe and healthy pregnancy on the Tommy’s website >

Your immune system protects the body from infection by finding and killing germs, bacteria or viruses. Surgery doesn’t usually have a big impact on your immune system. However, getting COVID-19 before or after surgery may increase your risk of complications. 

Your hospital is doing as much as possible to reduce this risk. When your healthcare team are supporting you to make treatment decisions, they will consider the risk of COVID-19 as part of this. In most hospitals we have spoken to, surgeries are continuing as usual for cervical cancer patients. But your healthcare team may talk to you about:    

  • delaying your treatment
  • changing to a different treatment
  • using telephone calls and video calls to avoid face-to-face appointments where possible
  • having a test to check for COVID-19 before your surgery. 

Read about COVID-19 and healthcare >

More information and support about trachelectomy

Any type of surgery for cervical cancer can have a huge impact on your physical and emotional wellbeing. Your healthcare team, both at the hospital and at your GP surgery, are there to support you with any questions or worries you have. 

Remember that we are here for you too, whether you are waiting to have surgery, are in recovery, or are years past it. Our trained volunteers can listen and help you understand what’s going on via our free Helpline on 0808 802 8000. 

Check our Helpline opening hours >

 

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.

Join our Forum >

 

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it.

References

  • British Gynaecological Cancer Society (2020). Cervical Cancer Guidelines: Recommendations for Practice. Web: www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf. Accessed October 2020.
  • Cibula, D. et al (2018). The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Radiotherapy Oncology. 127;3. pp.404-416.
  • Tirlapur, A. et al (2017). The management of pregnancy after trachelectomy for early cervical cancer. The Obstetrician & Gynaecologist. 19. pp.299– 305. 
  • Rojas, C. et al (2015). Radical and Simple Trachelectomy. Medscape. Dec 2015: https://emedicine.medscape.com/article/2046552-overview

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

Read more about how we research and write our information >

Having a trachelectomy >

Find out what happens before, during and after surgery.

"I chose to have a trachelectomy because I want to have children in the future."
Read Stephanie's story
Date last updated: 
03 Nov 2020
Date due for review: 
01 Nov 2023
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