When is radical hysterectomy recommended for womb cancer?

A radical hysterectomy is a larger operation than a simple hysterectomy. It removes the womb, cervix and some tissues beside the cervix; nearby lymph nodes may also be assessed. The exact operation depends on the tumour's position and whether it involves the vagina, pelvic tissues or other structures. A gynaecological cancer team weighs the biopsy type, scan findings, cancer stage, general health and the aim of treatment.

It is not automatically used for every womb cancer. Some cancers are treated with a less extensive operation, medicines, radiotherapy, or a combination. Fertility is usually lost after removal of the womb, so this should be discussed before treatment.

Ask how the biopsy and scans describe the cancer and whether the cervix or tissues outside the womb are involved. Your team may discuss an examination, imaging, blood tests and an operation plan, including possible removal of lymph nodes. Tell them about previous operations, medicines, allergies, bowel or bladder symptoms, and any wish to preserve fertility. Ask what recovery, urinary or bowel changes, sexual effects and further treatment could involve.

A second opinion from a specialist gynaecological cancer team can help when the proposed operation is extensive or the diagnosis is uncertain.

Contact your cancer team promptly for heavy or persistent vaginal bleeding, new pelvic pain, fever, faintness, or difficulty passing urine or stool. After surgery, urgent assessment is needed for worsening pain, heavy bleeding, chest pain, breathlessness, or a swollen painful leg.

Which findings make a radical hysterectomy suitable in my case? What tissues and lymph nodes might be removed? Could another treatment or a less extensive operation meet the same goal? How might this affect bladder function, bowel function, sex and fertility?