How does the Women’s Surgery Center treat cervical cancer?
Different types of treatment are available for patients with cervical cancer. The three types of standard treatment are surgery, radiation therapy, and chemotherapy. Surgery is commonly used to treat cervical cancer and is the only cure for the disease.
The type of surgical procedure that is needed depends upon the stage and grade of cervical cancer. Small, highly localized areas of precancerous cells or early stages of cervical cancer may be treated with cryosurgery, loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) . Cryosurgery uses an instrument to freeze and destroy a small area of abnormal tissue. A LEEP can be used for slightly more invasive cells because it uses a thin wire loop to cut away a small area of tissue. CKC can also be used to remove a small area of precancerous or cancerous cells. CKC is effective for lesions within the opening of the cervix or cervical canal. Some of these minor surgical procedures may be able to be performed in the office.
For cervical cancer that is not localized to the cervix or for patients who do not wish to preserve future fertility, hysterectomy, removal of the uterus and cervix, is typically the best treatment option as it prevents a recurrence of cervical cancer.
Laparoscopic hysterectomy offers women all of the benefits of minimally invasive surgery, including short to no hospital stay, minimal pain and fast recovery. The Women’s Surgery Center has found that a fast and easy recovery from surgery benefits cancer patients in particular. After laparoscopic surgery, women feel less sick, which enables them to have a brighter, more optimistic outlook. This positive outlook helps women through the rest of the cancer treatment and recovery process.
Laparoscopic Hysterectomy for Cervical Cancer
The Women’s Surgery Center treats patients with cervical cancer laparoscopically. We perform the most laparoscopic hysterectomy and staging for cervical cancer in the Mid-Atlantic region.
Laparoscopic Modified Radical Hysterectomy (LMRH) is a revolutionary procedure for the surgical management of early stage cervical cancer. The Women’s Surgery Center performed the first LMRH in the Washington DC metro area years ago and our surgeons have been performing and perfecting this procedure since. This is a technically difficult procedure that, in experienced hands, yields excellent results with much improved recovery and function.
During a LMRH, the uterus and cervix are removed, and the tissue on the sides of the cervix needs to be removed as well. To do this, the ureter, the tube that transports urine from the kidney to the bladder, needs to be carefully separated from the tissue surrounding the cervix in order to remove the potentially cancerous tissue without harming the ureter. This is the most difficult part of the operation. Ureter complications, including nicks and cuts, are the most common type of surgical complication with this and any other gynecologic surgery.
Staging is performed at the time of the laparoscopic procedure to determine if the cancer has spread, and involves node dissection, or removal of the lymph nodes during the procedure. The removal of lymph nodes does not add time or additional complications to the surgical procedure. The Women’s Surgery Center uses a sophisticated Advanced Laparoscopic technique that allows us to remove more nodes completely than other surgeons.
The Advanced Laparoscopic technique used by the Women’s Surgery Center allows our surgeons to completely isolate the ureter from the surrounding tissues and safely remove potentially cancerous tissues without harming the ureter and other essential structures. In fact, the Women’s Surgery Center has a surgical complication rate of less than 1%, which is many times lower than any other published complication rates for similar surgeries.
All patients with early stage cervical cancer are candidates for the procedure. A comparison chart below shows the dramatic difference in incision size and recovery, and the benefits of laparoscopic surgery should radiation therapy be required after surgery.
Comparison Chart
Laparoscopic Modified Radical Hysterectomy versus Open Modified Radical Hysterectomy
| Lapscope MRH - WSC | Open MRH | |
| Discharge Home | Less than 24 hours | 3 to 5 days |
| Recovery Time | 2 weeks or less | 6 – 8 weeks |
| Incision Size | 4 – 1/4 inch | 6 to 8 inches, horizontal |
| Pain Tolerance | Excellent to good, moderate pain first 2 days | Fair to poor secondary to large horizontal incision |
| Node Yield | Average 18, range 12 to 28 nodes | Variable, depends on surgeon |
| Complications | Minimal secondary to small incisions, minimal pain, rapid discharge from hospital, immediately ambulatory. Minimal adhesion formation decreasing complications from radiation therapy if required. Five to ten percent of patients will require placement of bladder catheter for urinary retention secondary to the procedure | Incision: increased incidence of wound breakdown and infection, incisional pain, pain with breathing. Ambulation: difficulty ambulating with increased incidence of clot in legs and lungs due to venous stasis. Other: Increased incidence of radiation injury to small bowel due to adhesion formation, increased incidence of stroke and MI due to venous stasis and stress/pain, lung collapse and pneumonia, increased risk of hospital acquired infection (MRSA) secondary to prolonged hospital stay. Higher percentage of patients will require bladder Pcatheter placement for urinary retention secondary to the procedure. |
| Procedure Time | 1.5 to 2 hours | 2 to 3 hours |