Cervical Cancer Treatment
Stages of Cervical Cancer
Key Points for this Section
After cervical cancer has been diagnosed, tests are done to
find out if cancer cells have spread within the cervix or to other parts of the
The process used to find out if cancer has spread within the
cervix or to other parts of the body
is called staging. The information
gathered from the staging process determines the stage of the disease. It is important to know the
stage in order to plan treatment. The following tests and procedures
may be used in the staging process:
- Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- CT scan (CAT
scan): A procedure that makes a series of detailed pictures of areas inside the
body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography,
computerized tomography, or computerized axial tomography.
A procedure used to x-ray the lymph
system. A dye is injected into the lymph vessels in the feet. The dye travels upward through the lymph
nodes and lymph vessels, and x-rays are taken to see if there are any blockages. This test helps find out whether cancer has spread to the lymph nodes.
- Pretreatment surgical staging: Surgery (an operation) is done to find out if the
cancer has spread within the cervix or to other parts of the body. In some
cases, the cervical cancer can be removed at the same time. Pretreatment
surgical staging is usually done only as part of a clinical trial.
- Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
- MRI (magnetic
resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Fine-needle aspiration (FNA) biopsy:
The removal of tissue or fluid, using a thin needle.
The results of these tests are viewed together with the results of
the original tumor biopsy to
determine the cervical cancer stage.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for cervical cancer:
Carcinoma in Situ (Stage 0)
In carcinoma in situ (stage 0), abnormal cells are found in the innermost lining of the cervix. These abnormal cells may become cancer and spread into nearby normal tissue.
Millimeters (mm). A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm.
In stage I, cancer is
found in the cervix only. Stage I is divided into stages IA and IB, based on
the amount of cancer that is found.
Stage IA: A very small amount of cancer that can only be seen
with a microscope is found in the tissues of the cervix. Stage IA is divided into stages IA1 and IA2, based on the size of the tumor.
- In stage IA1, the cancer is not more than 3 millimeters deep and not more than 7 millimeters wide.
- In stage IA2, the cancer is more than 3 but not more than 5 millimeters deep, and not more than 7 millimeters wide.
Stage IB is divided into stages IB1 and IB2.
In stage IB1:
- cancer can be seen only with a microscope and is more than 5 millimeters deep and more than 7 millimeters wide; or
- the cancer can be seen without a microscope and is 4 centimeters or smaller.
- In stage IB2, the cancer can be seen without a microscope and is larger than 4 centimeters.
In stage II, cancer
has spread beyond the cervix but not to the pelvic wall (the tissues that line the part of the
body between the hips) or to the lower third of the vagina. Stage II is divided into stages IIA and IIB, based on
how far the cancer has spread.
Stage IIA: Cancer has spread beyond the cervix to the upper
two thirds of the vagina but not to
tissues around the uterus.
Stage IIA is divided into stages IIA1 and IIA2, based on the size of the tumor.
- In stage IIA1, the tumor can be seen without a microscope and is 4 centimeters or smaller.
- In stage IIA2, the tumor can be seen without a microscope and is larger than 4 centimeters.
- Stage IIB: Cancer has spread beyond the cervix to the tissues around the uterus.
In stage III, cancer
has spread to the lower third of the vagina, and/or to the pelvic
wall, and/or has caused kidney problems. Stage III is divided into stages IIIA and IIIB,
based on how far the cancer has spread.
In stage IV, cancer
has spread to the bladder, rectum,
or other parts of the body. Stage IV is divided into stages IVA and IVB, based
on where the cancer is found.