Surgery for Small Cancers and Precancerous Lesions

The following surgical procedures may be used for precancerous lesions or for cancerous tissue that has not spread beyond the cervix.

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Cryosurgery (cryotherapy): This surgical procedure uses an instrument to freeze and destroy precancerous tissue. This is not used on invasive cancer. The advantage to this procedure is that it can be performed in the doctor's office and women typically do not experience any bleeding after the exam. One disadvantage to this therapy is that no tissue is removed, which means there is nothing to be evaluated under a microscope. This type of procedure also has the potential for missing a cancer or causing a change in the cervical mucus.

Laser surgery: This surgical procedure uses a narrow laser beam to destroy precancer cells. This is not used on invasive cancer. A benefit of laser treatment is its precision; it destroys only diseased tissue inside in the cervix. One disadvantage to this therapy is that the tissue is destroyed and therefore cannot be evaluated under a microscope. This procedure is performed in an operating room.

LEEP (loop electrosurgical excision procedure): This procedure uses electrical current passed through a thin wire hook. The hook removes the tissue. This is primarily used on precancerous lesions under local anesthesia. The advantage of this procedure is that more of the tissue can be removed for evaluation and the chances of cure are greater. There is some bleeding after the procedure.

Cone: A gynecologist uses the same procedure as a cone biopsy to remove all of the cancerous tissue. This procedure can be used in a woman who has a very small cervical cancer and who wishes to preserve the ability to have children. It is performed in the operating room, and more of the tissue can be removed for evaluation. There is some bleeding after the procedure.

Hysterectomy: This operation removes the uterus and the cervix. If a woman has a hysterectomy, she will no longer be able to have children. This kind of hysterectomy is performed only on women with very small cervical cancers, less than 3 millimeters in depth.

Bilateral salpingo-oophorectomy: In this procedure, the fallopian tubes and ovaries are removed at the same time as the hysterectomy. If a woman is close to the age of menopause, her doctor may discuss removing her ovaries and fallopian tubes to reduce the chance that the cancer will recur in one of those organs.

Side effects from surgery vary depending on the procedure. Some women have excessive bleeding, infection, or damage to the urinary and intestinal systems. Most of the risks are very small and temporary.