Cervical Cancer Staging

Your Cancer Status

If a biopsy shows that you have cancer, your doctor needs to learn the grade and stage (extent) of the disease to help you choose the best treatment. A pathologist assigns the grade (1 to 3) to describe how abnormal the cancer cells look under a microscope. Grade 1 cancer cells are not as likely to grow and spread as Grade 3 cells. 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.

To learn the extent of the 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 (Magnetic Resonance Imaging): 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 (Positron Emission Tomography 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.

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.