Dear OncoLink "Ask The Experts,"
I was treated for cervical cancer a year ago with a radical hysterectomy. Six months went by and I had a recurrence and underwent radiation along with cisplatin chemotherapy. This treatment did not rid me of all the cancer and I am now facing a pelvic exenteration. I can't find much information about this surgery. Can you tell me what you know about it?
Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:
Pelvic Exenteration is a radical surgical procedure used in just the situation you describe, when lesser surgery and radiotherapy have not been successful in controlling cervical or uterine cancers. If the tumor is confined to the central pelvis, cure may still be possible with exenteration. Because the tumor will be in close contact with the bladder and rectum, removal of one or both of these organs will be a part of the surgery. The urinary and/or intestinal tract can be reconstructed, as can the vagina, if its removal is needed. If there is any evidence of spread of the cancer beyond the central pelvis, the operation should not be performed.
Although pelvic exenteration involves a lengthy and difficult surgical procedure and a prolonged recovery, many patients have been cured of recurrent cancer by this means, and have gone on to live relatively normal lives. An operation of this type should only be performed by an experienced gynecologic cancer surgeon at a major cancer center.