Radical hysterectomy is a common mode of treatment for early-stage cervical cancer and includes the removal of ovaries and fallopian tubes along with the uterus.
The diagnosis of cervical cancer and the resultant hysterectomy surgery came as a jolt for Anita Suri (name changed on request), a 30-year-old woman from Delhi. Anita, already grieving the loss of her husband who had been in the army, wasn’t prepared for this new and unwelcome health update.
Anita entered the OPD (outpatient department) of a gynecologist in 2020 to probe her ill health. Even before she enunciated her symptoms, her body gave away key cues to the gynecologist who recalls her body effusing a foul odour when she entered the consulting room.
The gynecologist immediately attributed the distinct smell to an abnormal vaginal discharge, a telltale sign of something being seriously amiss.
Anita was diagnosed with stage 2 cervical cancer. Since cancer hadn’t clawed its hold beyond her cervix and uterus, uterus removal was deemed a suitable measure to free her from the grip of the disease.
Anita underwent a radical hysterectomy, removing her uterus, cervix, fallopian tubes, and ovaries, successfully sending her cancer into remission.
She has been cancer-free post her hysterectomy and got a respite from her chemotherapy and radiotherapy sessions. However, she has to do regular follow-ups with her gynecologist to look for any signs of relapse.
Types of hysterectomy
According to Dr Hirday Kapoor, consultant, obstetrics & gynecology, Cloudnine Hospitals, Delhi, hysterectomy is the surgical removal of the uterus.
Dr Kapoor elaborates on the types:
- Total hysterectomy: The removal of the entire uterus, including the mouth of the uterus (called the cervix).
- Partial hysterectomy: In partial hysterectomy, only the uterus is removed, while retaining the cervix.
- Hysterectomy with oophorectomy: In this type, the ovaries and fallopian tubes are removed along with the uterus.
- Radical hysterectomy: In a radical hysterectomy, along with the cervix and uterus, the ovaries, fallopian tubes, tissues surrounding the cervix, and pelvic and abdominal lymph nodes are removed.
Cervical cancer care: When to remove uterus?
According to Dr Uma Dangi, consultant in medical oncology, Fortis Hospital, Mumbai, a hysterectomy is a preferred mode of treatment in the early stages of cervical cancer up to stage 2A, where the cancer is restricted to the top of the vagina and has not spread to the tissues surrounding the uterus. A radical hysterectomy is most commonly done for cervical cancer.
“Beyond stage 2A, when the parametrium (the tissues surrounding the uterus) gets involved, uterus removal doesn’t help and chemoradiation (a combination of chemotherapy and radiation therapy) is required,” says Dr Dangi.
According to Dr Sandhya Rani, senior consultant, obstetrics & gynecology, Aster Women & Children Hospital, Bengaluru, “If the cancer is picked up early during the precancerous stage, hysterectomy can be avoided with minimally invasive procedures which include surgically removing the affected part of the cervix, instead of the whole uterus.
Can a relapse happen after a hysterectomy?
Shedding light on the chances of relapse post a hysterectomy Dr Rani says, “The chance of relapse depends on the stage of cancer. If the cancer is localised (no spread has happened), and if a significant margin surrounding the area is operated on and removed, the chances of relapse are very less. In case of stage 1 or stage 2A, the chance of relapse is less if we do a radical hysterectomy. This is where the importance of early detection and screening tests like Pap smear (a test to detect cervical cancer) comes into the picture.”
What to expect after a hysterectomy?
Dr Rani says hysterectomy done for cancer is major surgery and requires more time for recovery. “Sometimes one may experience swelling in the legs and difficulty in urination, irregular bowel movements and constipation during the postoperative period,” she says.
Dr Kapoor also mentions the occurrence of hot flashes and mood fluctuations if the ovaries are removed due to the drastic drop in estrogen and progesterone levels. “All these are short-lived and go away in a short time,” she says.
- Hysterectomy can be an effective treatment for early-stage cervical cancer.
- It is a choice of treatment up to stage 2A of cervical cancer after which chemoradiation is required.
- Radical hysterectomy is most commonly done for cervical cancer treatment.