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Cervical Cancer Staging Explained: A Crucial Step in Treatment Planning
By Raveena M Prakash
Cervical cancer is a type of cancer that affects the cells in the cervix of women. According to WHO, cervical cancer is the fourth most common cancer generally developed in women. This cancer develops when the cells in the cervix start to become precancerous cells. If you are diagnosed with this type of cancer or experiencing any symptoms of this cancer, then read further! If you are concerned about your cervical cancer staging and how treatment options might give better outcomes, then this blog is for you!
In this article, we'll explore more about its cancer stages and why staging is a crucial step for treating this cancer!
What is cervical cancer
Cervical cancer is generally developed on the surface of the cervix. This type of cancer happens when the cells on the cervix start to change as precancerous cells. One of the common causes and risk factors responsible for this cancer is the human papillomavirus infection. HPV is a virus that is often transmitted through sexual intercourse with an infected person.
Types of cervical cancer
There are mainly two types of cervical cancer observed in people.
- Squamous cell carcinomas: About 80% to 90% of cancers are squamous cell carcinomas.
- Adenocarcinomas: About 10% to 20% are adenocarcinomas.
However, people can have a mix of both these cancers.
Symptoms and causes
The early symptoms of cervical cancer are often difficult to detect. This cancer usually doesn’t show any signs and symptoms, which makes it really hard to find out in the initial stages.
The first symptoms of this cancer may include:
- Abdominal pain
- Fatigue
- Feeling of illness
- Diarrhea
- Weight loss
- Loss of appetite
- Watery or bloody discharge from the vagina
- Bleeding after sex
- Painful sex
If you are experiencing symptoms such as abdominal pain, bleeding, any unusual vaginal discharge, or any other symptoms for more than two weeks, then consult a doctor.
However, some of these symptoms can develop due to any common illness. It doesn’t always mean you are diagnosed with cancer. Try not to panic; consult a doctor when these signs are not improving.
Diagnosis and tests
Early diagnosis of this type of cancer helps survival and increases the chance of recovery. However, this cancer usually develops slowly, and some of these symptoms go unnoticed or overlooked due to their nonspecific reasons.
Here are some of the tests used to diagnose this cancer:
- Colposcopy
- Punch biopsy
- Endocervical curettage
- Loop electrosurgical excision procedure
- Cone biopsy
Risk factors for cervical cancer
In the majority of cases, these cancers are caused by HPV infection. The HPV virus is transmitted through sexual intercourse. This viral infection can be contracted through anal, oral, and vaginal intercourse, which often leads to cancer in an infected person.
Other risk factors are:
- Excessive smoking and use of tobacco products
- HIV Infection
- Weak immune system
- Family history of cancer
- Multiple sexual partners
Cervical cancer staging
This cancer has four main stages, and within each stage, there can be several substages. The four main stages of this cancer may include:
Stage I: In stage I, the cancer has formed and is found in the cervix. This cancer is often divided into substages such as stage IA and IB, majorly based on the size of the tumor.
Stage II: In stage II, the cancer has already started to spread beyond the cervix and uterus. It hasn’t yet spread to your pelvic wall or your lower vagina.
Stage III: The cancer has spread to the lower part of the vagina, and this might spread to the pelvic wall, ureters (which are the tubes that carry the urine from the kidneys to the bladder), and nearby lymph nodes.
Stage IV: This is the most advanced stage of cancer. In this stage, the cancer has spread into the bladder, rectum, or other parts of the body, such as bones and lungs.
Treatment options for cervical cancer by stage
Stage IA1
Treatments used for this stage of cancer mainly depend on the patient. Whether they want to have children in the future or if the cancer has grown into the blood or lymph nodes, also known as lymphovascular invasion.
If the patient wants to have children, then these treatment options are used. These may include:
- Cone biopsy: A cone biopsy is recommended in patients if they want to have children in the future.
- Radical trachelectomy: If the patient has positive margins, which indicates cancer cells in the cone biopsy, then it might have been treated with a repeat cone biopsy or radical trachelectomy.
Treatment options, if you don’t want to maintain fertility
- Hysterectomy
- Radical Hysterectomy
- External beam radiation
- Brachytherapy
Stage IA2
The treatment options for this stage mainly depend on whether or not the patient wants to have children.
Treatment options if the patient wants to maintain fertility:
- Cone biopsy along with the removal of lymph nodes, also known as pelvic lymph node dissection
- Radical trachelectomy with lymph node dissection
Treatment options if the patient does not want to have kids:
- External Beam Radiation Therapy
- Radical hysterectomy with the removal of pelvic lymph nodes
Stage IB and Stage IIA
Treatment options if the patient wants to have kids:
- Radical trachelectomy with pelvic lymph dissection; in some cases, the para-aortic lymph nodes are removed.
Stages IB1, IB2, and IIA1
Treatment option if the patient doesn't want to maintain fertility.
- Radical hysterectomy
- Radiation therapy
Stages IB3 and IIA2
Treatment options may include:
- Chemoradiation: The treatment is often given with external beam radiation therapy, and this can be followed by brachytherapy.
- Radical hysterectomy: This treatment is often performed with pelvic lymph node dissection and para-aortic lymph node sampling.
- Brachytherapy: This treatment is often performed with other treatments such as chemoradiation and hysterectomy.
Stages IIB, III, IVA
Treatment option may include:
- Chemoradiation treatment: This treatment option can be given to the patient along with external beam radiation therapy (EBRT). This treatment may be followed by brachytherapy.
Stage IVB
At this stage, the cancer has spread outside the pelvis to other areas of the body. However, Stage IVB is considered not curable. There are several treatments used to give the patients to reduce the severity of symptoms.
Treatments may include:
- Chemotherapy
- Radiation therapy
- Immunotherapy
- Targeted therapy
Treatments
Treatments for this cancer are often based on many factors, including the patient’s age, cancer stage and growth, individual medical conditions, and if the patient wants children in the future.
The treatments for this cancer may include:
Surgery: There are different types of surgeries used to treat this type of cancer. These tissues get removed when the cancer is in the early stages. Some of the most common kinds of surgeries may include.
- Laser surgery: This surgery often uses a laser beam to burn off just the cancer cells.
- Cryosurgery: This surgery is used to freeze cancer cells, destroying them.
- Hysterectomy: This surgery involves removal of the uterus and cervix in the patients.
- Trachelectomy: This surgical procedure removes your cervix and the upper part of the vagina, not the uterus.
- Pelvic exenteration: This is the same as a hysterectomy but also includes the bladder, vagina, rectum, and part of your colon, depending on where the cancer has spread.
Chemotherapy: This treatment can also be used to treat this type of cancer. Chemotherapy can also be given through injection or pill form.
Radiation therapy: This type of treatment often uses intense energy beams to destroy or kill cancerous cells. However, there are two types of radiation therapies that are used.
These may include:
- External Beam Radiation Therapy (EBRT): This uses high-powered radiation to the cancer cells from a machine outside your body.
- Brachytherapy: In this treatment, the radiation might be placed near the cancer cells.
Targeted therapy: Targeted therapy is another effective treatment method used for treating this type of cancer. This method is used especially to target cancer cells while avoiding healthy cells getting harmed.
Immunotherapy: This treatment method is often used to stimulate the immune system to recognize and destroy the cancer cells in the patient's body.
Prevention
It can be prevented through regular gynecological exams and getting Pap tests. These screening tests help to identify this cancer in the early stages. However, this type of cancer can be prevented by following some precautionary measures.
These may include:
- HPV vaccination for cervical cancer
- Using protection and condoms during sex
- Limiting your sexual partners
- Stop smoking and using tobacco products
Consult Today
Cervical cancer is a life-threatening disease. However, this cancer is highly treatable and manageable if diagnosed in the early stages. Being diagnosed with any cancer can feel highly devastating to handle. But the good news is, it can be identified with regular cervical cancer screening tests. Pap tests detect most cases of cancer in the cervix, along with HPV tests.
If you or any loved ones are experiencing any symptoms or are diagnosed with this type of cancer, visit Oncare Cancer Center’s website and book an appointment today.
At Oncare, you can get a personalized consultation from our experienced cancer specialists and also get an estimated cost of your cancer treatment now!
Frequently Asked Questions
Yes, cervical cancer can be a curable and treatable disease if it's diagnosed in the early stages. Oncologists mostly use the term called remission, which means that the cancer has been cured, but there’s still a chance of recurrence in people.
Yes, cervical cancer can be prevented with regular screening tests, and getting Pap tests is the most important step to initiate the prevention of this type of cancer in women. Additionally, vaccination for cervical cancer often helps with HPV infection-related cancer in people.
- Getting the HPV vaccination
- Practicing safe sex
- Stop smoking and the use of tobacco products.
- Limiting multiple sexual partners
There are many risk factors known for developing cervical cancer in people. Some of the risk factors can be controlled, while there are some risk factors that can’t be controlled, such as age, gender, family history of cancer, and genetic mutations.
Risk factors that can be controlled may include
- No screening history
- HPV infection
- Sexual encounters with multiple partners
- Smoking habits
- HIV infections
- Having weak immune systems
Cervical cancer cells often look different under a microscope when they're compared to normal, healthy cells. Some of the major features of cervical cancer cells are
- They have different sizes and shapes.
- Loss of structure
- A darkened center
- An increased fluid level
At stage IV, the chance of recovery or complete cure from cervical cancer is very low. However, remission is possible for some patients. This is the most advanced stage of cervical cancer. In this stage, the cancer cells have spread to other organs and tissues throughout the body. In this stage, treatment options such as radiation therapy, chemotherapy, and targeted therapy are better treatment options to extend life and also improve the quality of life.