Recognized worldwide for his surgical skills, gynecological cancer research, and pioneering treatment strategies using minimally invasive surgery, Dr. Farr Nezhat is frequently invited to speak at national and international congresses, where he is often asked to demonstrate his innovative techniques for the laparoscopic and robotic management of cervical cancer.
What is cervical cancer?
Cervical cancer originates in the cervix, which is the lower part of the uterus that connects to the top of the vaginal canal.
Most cervical cancers are squamous cell carcinoma, which begins in the cells lining the outer par of the cervix which projects into the vagina. Adenocarcinoma begins in the glandular cells lining the cervical canal.
It currently affects 13,000 women per year in the U.S.
Cervical cancer most often affects women between the ages of 35 and 45, but more than 15% of cases are found in women over age 65.
The cause of almost all cases of cervical cancer is known to be HPV (human papillomavirus), a persistent longstanding infection that develops into cancer.
Vaccination is available for girls and women aged 9 to 26. This reduces the risk of cervical cancer and is most effective if administered before becoming sexually active.
What are the symptoms of cervical cancer?
- Abnormal vaginal bleeding (such as between periods, after intercourse, or after menopause)
- Vaginal discharge that is watery, pale or bloody
- Pain during intercourse
- Heavy periods that may last longer than usual
- Pelvic pain
What are the risk factors for cervical cancer?
The risk of cervical cancer is greatly reduced by using screening tests such as Pap smear and HPV testing, enabling detection of high-risk strains of HPV, early treatment and improved outcome.
- History of abnormal pap smears
- Having many sexual partners or a partner who has many sexual partners (increases likelihood of exposure to HPV)
- Sexual activity at an early age
- Having other sexually transmitted infections (such as chlamydia, gonorrhea, syphilis and HIV/AIDS)
- Weakened immune system
- Smoking (associated with squamous cell cervical cancer)
What treatment options does Dr. Nezhat offer for cervical cancer?
Dr. Nezhat specializes in the application of minimally invasive surgical techniques to treat cervical cancer. He performs all the standard procedures historically performed via open surgery, but he does so through small incisions.
These procedures include radical trachelectomy (removal of the cervix and surrounding tissues but leaving the uterus intact), simple hysterectomy (removal of the uterus and cervix without removal of additional tissue on the side of the cervix or any vaginal tissue), radical hysterectomy (removal of the uterus, cervix, some of the tissue surrounding the cervix and a small portion of the vagina), lymph node dissection (or sentinel node dissection), and removal of ovaries (if indicated).
For very early cancer or precancerous cervical changes, cervical conization may be performed via vaginal approach. This involves cutting a wedge from the endocervical canal.
Dr. Nezhat offers surgical options that preserve fertility, consistent with the tenets of minimally invasive surgical interventions.
Sometimes open surgery is required, but the ultimate goal is to utilize the smallest incisions to remove all visible signs of disease and optimize outcome.
Dr. Nezhat has published extensively on the utility, safety and efficacy of minimally invasive surgery for gynecological malignancies.