Carcinoma of the residual cervical stump is becoming rare because supracervical hysterectomy is seldom if ever indicated. The reported incidence ranges from 2 to 7 per cent. The survival rates reported in several series are lower than those of patients with cancer of the intact uterus. Between September 1948 and November 1963, 238 patients with carcinoma of the cervical stump were seen at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston. Of these, 202 received definitive treatment, 5 received palliative treatment for relief of pain or for hemostasis, 10 refused treatment, and 21 were too advanced for treatment. Of those patients receiving definitive therapy, 191 (94.5 per cent) had squamous-cell carcinoma and 11 (5.5 per cent) had adenocarcinoma. The interim between supracervical hysterectomy and the diagnosis of cancer is important. If carcinoma is diagnosed shortly after a supracervical hysterectomy, it must have been present before surgical treatment; therefore, the situation and prognosis are very different. Most authors have chosen a two-year interval between the subtotal hysterectomy and the diagnosis of cancer. With use of this span for this series, there are 5 cases of coincidental stump cancer. Radiation Management The absence of the uterine cavity makes intracavitary radium therapy less effective than when the uterus is present, because the zone of effective irradiation does not reach the end of the stump and radiation sources inserted up to the fundus are necessary to achieve adequate irradiation of the paracervical areas (Fig. 1). Whole-pelvis external irradiation is used to compensate for the absence of uterine radium. Since 1954, when mega voltage radiation became available, all patients except those with early Stage I lesions have been treated with initial whole-pelvis irradiation, using a 22-MeV beam, which affords a homogeneous coverage of pelvic structures with minimum skin and subcutaneous doses (3). Two intracavitary radium applications may be performed two weeks apart, as for carcinomas of the intact uterus, provided that the disease is early and apparently limited to the lips of the cervix, the cervical canal is deep enough to accommodate at least 1 radium source, and the vault is adequate for 2 colpostats. As a rule, a 25-mg source is placed in the canal. In 98 patients, a residual canal allowed insertion of at least 1 radium source. When there is no room for any type of radium source in the cervical canal, combined transvaginal therapy (usually 140 kV) and vaginal radium are used. Vaginal radium alone does not give an appreciable depth dose to the end of the stump. Transvaginal therapy adequately irradiates to a depth of 3 to 4 cm but does not give a sufficient dose to the vaginal mucosa outside the aperture of the cone. Vaginal radium supplements the dose to the vaginal mucosa.