Cervical cancer is a condition where cancerous cells invade the cervix, the part of the body that connects a woman's uterus to the vagina. The cervix enlarges during childbirth and serves as a passageway for the baby to move from the uterus to the vagina. Cervical cancer almost always requires surgery, but the surgical procedures are quite different depending on how far the cancer has spread. Some surgeries even allow the patient to avoid permanent infertility.
Surgery During Early Stages
Women in the extremely early stages of cervical cancer may be able to have surgery that will allow them to still have children. A cone biopsy or loop electrosurgical excision only removes the part of the cervix that contains cancerous cells. Cryosurgery kills the cancer cells by freezing them, and laser surgery destroys the cells by burning them. All of these surgeries are for women with non-invasive cancer and may be the only treatment necessary if all the cancer cells are removed. Although they require general anesthesia, they are usually done in an outpatient surgery center. The patient is able to go home shortly after the surgery and often has little discomfort and a quick recovery
Middle and Late Stages
For women in the middle and later stages of cervical cancer, a hysterectomy is a common surgery. A simple hysterectomy removes the uterus and the cervix, but leaves the ovaries and fallopian tubes. A radical hysterectomy is available for women whose cancer has spread throughout the reproductive organs. The surgeon removes the uterus, cervix, ovaries, fallopian tubes and part of the vagina. Women with recurrent cervical cancer may have a pelvic exenteration. Along with the reproductive organs, the surgeon may also remove the bladder, rectum and part of the colon. A few women may have a trachelectomy. With this surgery, the cervix is removed, but the doctor puts a "purse-string" stitch in the uterus with the hope the woman will be able to conceive and deliver a baby by cesarean section. A trachelectomy is usually reserved for young women and has about a 50 percent fertility success rate; however, the miscarriage rate is fairly high.
Recovery Immediately After Extensive Surgery
The patient should do leg exercises in bed and deep breathing exercises after surgery. She should start walking as soon as possible. She can experience significant pain, and painkillers are often prescribed. Most women stay in the hospital six to eight days. Post-surgical weakness is common, along with some nausea and vomiting. Most patients start on liquids at first, and then gradually return to a diet of solid foods.
Later Recovery
It takes four to eight weeks for women to feel fully recovered from major surgery. Doctors suggest avoiding strenuous physical movement and heavy lifting for about eight weeks, and patients should avoid sexual intercourse for at least six weeks. Some patients have bladder or bowel complications after cervical cancer surgery, including difficulty urinating and constipation or diarrhea. For women with extensive cervical cancer, the doctor may also recommend chemotherapy and radiation to make sure all of the cancer cells are destroyed.
Menopause
Since a hysterectomy removes the reproductive organs, the woman will experience immediate menopause. Symptoms after cervical surgery may be more pronounced than during natural menopause. Hormone replacement medication can help with this problem, especially if the patient starts the therapy before surgery.
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