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 body.
- There are three ways that cancer spreads in the body.
- Cancer may spread from where it began to other parts of the body.
- The following stages are used for cervical cancer:
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:
- 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.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
- 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).
- 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. This picture can be printed to be looked at later.
- 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.
- Cystoscopy : A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
- Laparoscopy : A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples to be checked under a microscope for signs of disease.
- 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.
The results of these tests are viewed together with the results of the original tumor biopsy to determine the cervical cancer stage.
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if cervical cancer spreads to the lung, the cancer cells in the lung are actually cervical cancer cells. The disease is metastatic cervical cancer, not lung cancer.
Stage I is divided into stages IA and IB, based on the amount of cancer that is found.
- Stage IA: 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:
Stage IB is divided into stages IB1 and IB2, based on the size of the tumor.
- In stage IB1:
- the cancer can only be seen 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 wide or smaller.
- In stage IB2, the cancer can be seen without a microscope and is more than 4 centimeters.
- In stage IB1:
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 wide or smaller.
- In stage IIA2, the tumor can be seen without a microscope and is more than 4 centimeters.
- Stage IIB: Cancer has spread beyond the cervix to the tissues around the uterus.
Stage III is divided into stages IIIA and IIIB, based on how far the cancer has spread.
- Stage IIIA: vagina but not to the pelvic wall.
- Stage IIIB:
- Cancer has spread to the pelvic wall; and/or
- the tumor has become large enough to block the ureters (tubes that connect the kidneys to the bladder). This blockage can cause the kidneys to get bigger or stop working.
Stage IV is divided into stages IVA and IVB, based on where the cancer has spread.
- Stage IVA: organs, such as the bladder or rectum.
- Stage IVB:liver, lungs, bones, or distant lymph nodes.