The short answer: For early cervical cancer (bachedani ke muh ka cancer, बच्चेदानी के मुँह का कैंसर) that is still confined to the cervix and not too large, an operation called a radical hysterectomy is usually the main treatment. For most women it is done as open surgery, which has the best proven results; keyhole or robotic surgery is considered only for selected small tumours. Larger cancers are usually treated with chemoradiation instead of surgery, and some young women with a small cancer can have fertility-sparing surgery. Most women spend about 6–8 days in hospital after open surgery and need several weeks to recover at home. For a step-by-step guide to the operation itself, see understanding radical hysterectomy.
On this page
- Surgery as the Primary Treatment for Early Cervical Cancer
- What Is a Radical Hysterectomy?
- Laparoscopic vs. Robotic vs. Open Surgery
- Fertility-Sparing Surgery: Radical Trachelectomy
- Recovery and Post-Operative Expectations
Surgery as the Primary Treatment for Early Cervical Cancer
Surgery is usually the main treatment when cervical cancer is found early, is confined to the cervix and is not too large (usually stage IA2 to IB2). For younger women, surgery can allow the ovaries to be kept, which avoids an early menopause, and it avoids the long-term effects of radiotherapy to the pelvis. The usual operation is a radical hysterectomy together with removal or sampling of the pelvic lymph nodes (glands).
For larger or more advanced cervical cancers (generally stage IB3 and above), chemoradiation, which is radiotherapy (sikai) given with weekly chemotherapy and followed by internal radiotherapy (brachytherapy), is usually the main treatment rather than surgery. Your stage is worked out from the examination, biopsy and scans such as MRI.
What Is a Radical Hysterectomy?
Unlike a simple hysterectomy — which removes the womb (uterus) and cervix only — a radical (Wertheim) hysterectomy also removes the top of the vagina and the parametrium (the tissue on either side of the cervix that may contain tiny amounts of cancer spread). The pelvic lymph nodes are usually removed as well and checked under the microscope to see whether the cancer has spread to them. A radical hysterectomy does not always mean the ovaries are removed; in younger women they can sometimes be kept. To understand how this fits with the rest of your treatment, see our guide to cervical cancer diagnosis and care.
Laparoscopic vs. Robotic vs. Open Surgery
- Open (through a cut in the tummy, called laparotomy) — the standard approach for most early cervical cancers, with the best proven cancer results. Hospital stay is often about 6–8 days.
- Laparoscopic (keyhole) — small cuts, less blood loss and a shorter hospital stay, but for cervical cancer it is considered only for selected small tumours (usually under 2 cm).
- Robotic-assisted — also keyhole surgery, with the surgeon controlling the instruments from a console; hospital stay is often about 3–4 days. For cervical cancer it carries the same concern as laparoscopic surgery and is considered only for selected small tumours (usually under 2 cm).
Why the difference? In 2018 a large international study, the LACC trial, found that women with early cervical cancer who had keyhole or robotic radical hysterectomy had their cancer come back more often, and lower survival, than women who had open surgery. Smaller cuts and a quicker recovery do not make up for this. Our guide comparing open, laparoscopic and robotic radical hysterectomy explains the evidence in more detail.
The choice of approach is made jointly between the surgeon and patient, accounting for tumour size, MRI findings, the surgeon’s expertise, and the patient’s comorbidities. This discussion should always involve a gynaecological oncologist.
Fertility-Sparing Surgery: Radical Trachelectomy
For selected young women with stage IA2 to IB1 cervical cancer (tumour 2 cm or smaller) who wish to have children in future, a radical trachelectomy may be a safe alternative to hysterectomy. This operation removes the cervix and the tissue beside it (parametrium) but keeps the womb. Pregnancy is possible after recovery in many cases, naturally or with IVF, but these pregnancies need close specialist care. This must be discussed before any hysterectomy, so ask about it early if it matters to you.
Recovery and Post-Operative Expectations
After open radical hysterectomy, the standard for most women, the hospital stay is often about 6–8 days and recovery at home takes about 6–8 weeks. After robotic or laparoscopic surgery the stay is often about 3–4 days. Difficulty passing urine is common at first, because the nerves to the bladder run close to the cervix; some women go home with a urine catheter for a short time. It usually improves over the following weeks as the nerves recover, although in some women it takes longer. Our week-by-week guide to recovery after radical hysterectomy explains what to expect.
The final report on the removed tissue (histopathology) takes about 7–10 days. It shows whether the lymph nodes contain cancer, whether the edges (margins) are clear, and whether cancer cells are seen in small blood or lymph vessels (lymphovascular space invasion). These results decide whether radiotherapy or chemoradiation is advised after surgery.
To discuss cervical cancer surgical options with a subspecialist gynaecological oncologist in Ahmedabad, contact Dr. Nishtha Tripathi Patel at +91 76988 00333.