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Cervix Cancer

stage 1A
Cervix cancer stage 1A

Cervical cancer incidence has decreased over the last few decades mainly due to the introduction of a successful screening programme using smears. These days, one of the main risk factors for developing cervix cancer in the UK is ignoring the reminders for the regular cervical smears! Most cases of cervical cancer are prevented from occurring because a precancer is picked up on a smear and this is successfully and easily treated at a colposcopy consultation with a five minute procedure carried out under local anaesthetic! It is when this precancer is left untreated that it eventually after a few years will progress into a cancer.

cervix cancer stage 1B
Cervix cancer stage 1B

If this cancer is at its earliest stage (stage 1a1) then all it needs is big biopsy from the cervix (loop cone biopsy or knife cone biopsy) which still leaves most of your cervix behind and hardly affects your fertility or ability to hold onto a pregnancy without miscarriage or premature labour.

Cervix cancer stage 2
Cervix cancer stage 2

When the cervix cancer has grown to a larger size (and hence higher stage), we then have to take out the whole of the cervix or the whole womb (hysterectomy) along with pelvic lymph glands. If a hysterectomy is required then often it needs to be “radical” in contrast to the “simple” hysterectomy that is done for womb cancer or benign reasons such as heavy periods. A “radical” hysterectomy is different from a “simple” hysterectomy in that more of the supporting tissues and ligaments near the cervix have to be excised in order to obtain good margins and reduce the chance of recurrence. This extra tissue has other important structures passing through it such as the ureters (pipe draining the urine from kidneys to the bladder), nerves and blood vessels. These structures have to be carefully separated in order to allow the extra tissues to be removed with the hysterectomy specimen.

cervix cancer stage 3
Cervix cancer stage 3

The most common method of carrying out a radical hysterectomy in the UK has been the traditional open technique. A few centres do it using the conventional laparoscopic technique. Even fewer centres in the UK carry out this delicate surgery using the da Vinci robot! Indeed, in Guildford Surrey, we have the largest experience in the UK of carrying out the robotic radical hysterectomy.

Cervix cancer stage 4
Cervix cancer stage 4

When a cancer is suspected to be more than stage 2A, the preferred choice of treatment is radical chemoradiotherapy which is a combination of chemotherapy and radiotherapy. Once this treatment has been administered, a hysterectomy is not normally carried out except in very special circumstances.

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