Staging
If the biopsy shows that you have cancer, your
doctor needs to learn the extent (stage) of the disease to
help you choose the best treatment. Staging is a careful
attempt to find out whether the tumor has invaded
nearby tissues, whether the cancer has spread and, if
so, to what parts of the body. Cervical cancer spreads
most often to nearby tissues in the pelvis, lymph nodes,
or the lungs. It may also spread to the liver or bones.
When cancer spreads from its original place to
another part of the body, the new tumor has the same
kind of cancer cells and the same name as the original
tumor. For example, if cervical cancer spreads to the
lungs, the cancer cells in the lungs are actually cervical
cancer cells. The disease is metastatic cervical cancer,
not lung cancer. For that reason, it's treated as cervical
cancer, not lung cancer. Doctors call the new tumor
"distant" or metastatic disease.
Your doctor will do a pelvic exam, feel for swollen
lymph nodes, and may remove additional tissue. To
learn the extent of disease, the doctor may order some
of the following tests:
- Chest x-rays: X-rays often can show whether cancer
has spread to the lungs.
- CT scan: An x-ray machine linked to a computer
takes a series of detailed pictures of your organs. A
tumor in the liver, lungs, or elsewhere in the body
can show up on the CT scan. You may receive
contrast material by injection in your arm or hand,
by mouth, or by enema. The contrast material makes
abnormal areas easier to see.
- MRI: A powerful magnet linked to a computer is
used to make detailed pictures of your pelvis and
abdomen. The doctor can view these pictures on a
monitor and can print them on film. An MRI can
show whether cancer has spread. Sometimes
contrast material makes abnormal areas show up
more clearly on the picture.
- PET scan: You receive an injection of a small
amount of radioactive sugar. A machine makes
computerized pictures of the sugar being used by
cells in your body. Cancer cells use sugar faster than
normal cells, and areas with cancer look brighter on
the pictures.
The stage is based on where cancer is found. These
are the stages of invasive cervical cancer:
- Stage I: The tumor has invaded the cervix beneath
the top layer of cells. Cancer cells are found only in
the cervix.
- Stage II: The tumor extends to the upper part of the
vagina. It may extend beyond the cervix into nearby
tissues toward the pelvic wall (the lining of the part
of the body between the hips). The tumor does not
invade the lower third of the vagina or the pelvic
wall.
- Stage III: The tumor extends to the lower part of
the vagina. It may also have invaded the pelvic wall.
If the tumor blocks the flow of urine, one or both
kidneys may not be working well.
- Stage IV: The tumor invades the bladder or rectum.
Or the cancer has spread to other parts of the body.
- Recurrent cancer: The cancer was treated, but has
returned after a period of time during which it could
not be detected. The cancer may show up again in
the cervix or in other parts of the body.
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