Find out about the types of surgery for advanced cervical cancer and how you have them.
Advanced cervical cancer includes both cervical cancer that has spread at the time of your diagnosis, and cervical cancer that has come back after previous treatment.
What surgery involves
Surgery for advanced cervical cancer can involve many of the structures within the pelvis (the lower part of your abdomen). All the cancer will need to be removed, together with any lymph nodes the cancer may have spread into. How much surgery you have will be very individual. It will depend on where the cancer is.
Help and support
If you are having very major surgery, which could involve the removal of your bladder or rectum, a member of the stoma care team will come to see you before your operation. A stoma is an opening in the body.
A stoma is made if the rectum or bladder is removed. The stoma is covered with a bag that collects your urine or bowel motions. The stoma care team is a team of nurses who can help you to manage if you need this type of surgery. They will go through with you what will happen and what you will have to do after the operation.
If you agree, they may be able to introduce you to someone who has already had this type of surgery and can help to explain to you what it will involve and what it is like coping with this type of treatment. The stoma nurse will visit you after your operation too and help you to learn to look after your stoma and bag.
You may also be seen by a nurse who specialises in caring for people with cancer.
Before your operation, you may be asked to follow a diet sheet for a few days and take quite strong laxatives to make sure the bowel is as clean as possible. This helps to lessen the risk of infection after surgery and make the operation easier.
You may also need to have an enema when you get to hospital. Your nurse may need to shave your pubic hair to make sure the operation site is as clean as possible.
Types of surgery
Removing the womb, cervix, top of the vagina and lymph nodes as well as other organs is called pelvic exenteration. The aim of exenteration is to try to cure your cancer. Because it is a big operation, it is important that you are fit enough to make a good recovery. It is not suitable for everyone.
You usually have an examination under anaesthetic and a scan first to check if an operation is possible for you. This may be a CT scan, an MRI scan or a PET scan.
It is important to discuss this type of operation fully with your doctor or specialist nurse so that you know exactly what to expect after the operation.
There are 3 types of exenteration operations:
- anterior (front) exenteration
- posterior (back) exenteration
- total exenteration
Anterior (front) exenteration
In this operation you will have your womb, ovaries, cervix, top of the vagina and lymph nodes removed. Your bladder and lymph nodes around the bladder will also be removed.
After this operation you will have a urostomy and will need to have bags to collect your urine.
Posterior (back) exenteration
In this operation you will have your womb, ovaries, cervix, top of the vagina and lymph nodes removed. Part of your bowel and rectum will also be removed.
After this operation you will need to have a colostomy and you will have a bag to collect your bowel movements (poo).
In this operation you will have your womb, ovaries, cervix, top of the vagina and lymph nodes removed. You will also have the lower bowel, rectum and the bladder removed.
After this operation you will have both a colostomy and a urostomy. You will need to have a bag to collect your bowel movements and a bag to collect your urine.
Your doctors will make sure the benefits of having surgery outweigh these possible risks.
At your first follow up appointment, your doctor:
- gives you the results of the surgery
- examines you
- asks how you are and if you've had any problems
This is also your opportunity to ask any questions. Write down any questions you have before your appointment to help you remember what to ask. Taking someone with you can also help you to remember what the doctor says.
How often you have follow up appointments depends on the results of your surgery. Ask your doctor how often you need to have check ups and what they will involve.
You will have a follow up appointment after your surgery.