Is radical hysterectomy the only option?

Hello. I’ve had 2 Lletz procedures with cancer cells detected both times at a microscopic level. Have now been referred for a radical hysterectomy. I’m feeling really anxious about it. Particularly having lymph nodes removed and potential long term side effects. I’ve been researching less invasive options such as trachelectomy and sentinel node removal. I’m 46 and not looking to preserve fertility but am looking to remain active and travel etc. Anyone had any experience of challenging their treatment plan? Has anyone successfully argued to only have sentinel nodes removed? I’ve read that there is a trial but can’t find any details. I’ve emailed a bunch of questions to my consultant and to Jo’s ask the expert service but thought I’d reach out to the hive mind of you lovely ladies too.

Hi Charlotte2 and welcome

My situation was different to your but thought I would share some thoughts and experiences in case they might help.

Firstly to say, ou have a right to refuse any further treatment or to refuse parts of the treatment. The surgeons can’t perform any procedures on you without your signed consent. The important thing is that you make well informed decisions, so it’s good you’re asking various people for advice.

I was diagnosed with node negative stage 1B1 (new Figo 1B2) cc in 2017 and was advised to have a radical hysterectomy. I was very concerned about the risk for lymphoedema from the outset and enquired about sentinel node removal but my consultant said he didn’t offer the prodedure - my alternative was not to have any lymph nodes removed or possibly a random few. I thought about seeking sentinel node removal but yielded to advice that I shouldn’t delay, so as to preserve my node negative status plus my tumour was 3.8cm hence close to being inoperable. Also I was (incorrectly) assured I wouldn’t get lymphoedema because I’m slim - I ended up getting lymphoedema albeit I also had radiotherapy!

I believe a trachelectomy is usually only offered to those wishing to have children in the future: I don’t know if there would be any advantage for you in having one rather than a hysterectomy. Something you will probably need to consider is whether you wish to keep your ovaries so as to reduce the risk of early menopause; it wasn’t really an issue for me as I was post menopause when diagnosed.

x