Cervical cancer is divided into stages 1 to 4. Stages 1 and 2 belong to early and middle stages, and stages 3-4 belong to middle and late stages, and there are more detailed divisions within each stage. As far as surgery is concerned, all stages 1 and 2A can be considered for surgery, while stages 2B and 3-4 are not considered for surgery. There are several methods of surgery, depending on the patient’s requirement for fertility, the stage of the tumor, and the size of the lesion, radical hysterectomy, total hysterectomy, and extended hysterectomy (radical hysterectomy for cervical cancer) can be chosen. Besides the stage of the tumor, the patient’s age and physical condition are also important reference factors for whether surgery can be performed. Since cervical cancer surgery is extensive and traumatic, it requires patients to have a strong surgical tolerance. Therefore, if a patient is 60 years old, has chronic systemic diseases (such as heart disease, lung disease, chronic kidney disease, etc.), or other conditions that are estimated to be difficult to tolerate surgery, then one should not blindly go for surgery. Pursuing surgery at this point will not only fail to cure the disease, but may also bring about serious surgical complications or accidents. Radiotherapy can treat most cervical cancers and the effect is comparable to surgery It may be that for many tumors, inoperability to operate means losing the chance of cure. But for cervical cancer, this is not true, at least not for many patients! I would like to tell those cervical cancer patients who cannot undergo surgery that radiation therapy offers an equally good chance of treatment. Numerous studies have shown that radical radiotherapy for cervical cancer is actually not comparable to surgery! Therefore, for those patients mentioned earlier who are not suitable for surgery, doctors will recommend patients to go for radiotherapy. For cervical cancer treated for the first time, radiotherapy is not a palliative treatment, but rather a treatment method with radical effect as surgery. What should I choose between surgery and radiotherapy? Since radiotherapy is suitable for all stages, many patients are confused, I belong to the type that can be treated with both surgery and radiotherapy, how does the doctor help me choose the treatment plan? This starts with the pros and cons of surgery and radiation therapy. The biggest advantage of radiation therapy is that it is non-invasive and well-tolerated by patients. However, one of the major problems with radiation therapy is that there is inevitably some radiation damage to normal tissue, especially the ovaries. This is why young patients often need to protect the function of their ovaries, and surgery is a better option at this time. Even if a full tumor removal cannot be done for other reasons, the surgeon will perform a minor surgery to relocate the patient’s ovaries to avoid the area of radiation therapy. Cervical cancer surgery is a very big surgery in gynecology, and many patients cannot bear the blow of surgery; moreover, if the surgery cannot remove the tumor cleanly, then the effect of surgery will be greatly reduced. This is when the advantages of radiotherapy come into play. Compared with surgery, patients tolerate radiotherapy better, and radiotherapy can kill certain lesions that cannot be removed by surgery (or are not well removed). On the premise of equal treatment effect, radiotherapy is preferred for the elderly and frail, for those who do not need to preserve ovarian function, and for those whose tumors are beyond a certain extent. What is the problem with radiotherapy after surgery? Some patients have already had surgery, but their doctors ask them to go for radiotherapy. The reason is that the pathological examination after surgery shows that some patients belong to the high-risk group for recurrence of cervical cancer, so radiotherapy is needed to control these risk factors for recurrence and reduce the chance of recurrence in the future (the dose and protocol of postoperative radiotherapy is different from direct radiotherapy). Therefore, for those patients who are estimated to need further radiotherapy after surgery, many doctors believe it is better to have direct radiotherapy. Prevention of cervical cancer is better than cure The previous discussion on the treatment of cervical cancer is actually a means to “mend the fold”. The cause of cervical cancer is clearly HPV infection, so cervical cancer is a “completely preventable” disease. Therefore, cervical cancer is a “completely preventable” disease. If you have regular cervical checkups, consider cervical cancer vaccination if you have the conditions, and treat cervical lesions in time, cervical cancer will definitely stay away from you!