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Your gynae-oncologist will discuss the possibility of surgery with you. The decision about if you have surgery, and the type of surgery you have depends on the size of your cancer and if it has spread beyond the cervix. Your cancer staging will help to decide what treatment you receive. Cancers that have spread beyond the cervix will usually be managed with chemotherapy, radiotherapy or both. According to NHS guidelines, any major surgery for cervical cancer should be carried out in specialist cancer centres by a gynaecological oncologist (gynae-oncologist) or a gynaecologist with a specialist interest in cancer.
Surgery can range from treatments that affect only the cervix, such as large loop excision of the transformation zone (LLETZ) or cone biopsy, to more radical surgery involving a hysterectomy, where both the cervix and uterus (womb) are removed. Depending on the stage and extent of the cancer a selection of the lymph glands in the pelvis may also be removed, which is called a lymphadenectomy or lymph node dissection.
During a radical hysterectomy the cervix and uterus are removed, and parts of the fallopian tubes may also be removed. If a woman has already gone through the menopause then the ovaries are usually removed as well. However, in younger pre-menopausal women the ovaries will ideally be left as removing them brings on an early menopause. If it is necessary to remove the ovaries, the symptoms of the menopause can often be prevented by giving hormone replacement therapy (HRT) as tablets or skin patches. Your gynae-oncologist or nurse specialist will be able to discuss this with you in detail.
Both hysterectomies and lymphadenectomies can now be done laparoscopically (using keyhole surgery), which is sometimes done using robotic assistance. Please discuss these options with your health care professionals if you are interested in knowing more.
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