This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Cervical Carcinoma, Subject name: Gynaecology & Obstetrics
A female having carcinoma cervix stage IIIb. What is the treatment:- 
Select and explain. 
A. Weheims hysterectomy, B. Schauta's radical vaginal hysterectomy, C. Chemotherapy, D. Intracavitary brachytherapy with external beam radiotherapy
D: Intracavitary brachytherapy with external beam radiotherapy
Answer: D: Intracavitary brachytherapy with external beam radiotherapy 
Explanation: Rx of Cervical cancer NOTE: THERE IS NO ROLE OF SURGERY IN TREATMENT OF STAGE IIB AND ABOVE - Stage I - IIA - Surgical management: Radical Hysterectomy (aka type 3 hysterectomy) - Structures removed in radical hysterectomy are : Uterus, cervix, upper 1/3 - 1/2 of vagina, entire parametrium, uterine aery ligated at its origin from internal iliac aery, uterosacral ligament at most distal attachment (rectum) - Stage >= IIB - Chemoradiation - Radiotherapy alone is effective Rx in all stages. - Maximum radiation given at Point A 2cm above and 2 cm lateral to external os Ureter crosses the uterine aery (bridge over water) here ureter is under the uterine aery Parametrium seen here Upto 7500 to 8000 RADs given here Point B 3cm lateral to point B Obturator lymph nodes at the pelvis side walls Obturator lymph nodes -sentinel group of LN Upto 6000 RADS given here.