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What are the Stages of Cervical Cancer?

When faced with a cancer diagnosis, the prospect of navigating the various stages can be overwhelming. It’s natural to want to understand what will happen next and what you can expect along the way. For those facing or living with cervical cancer in particular, it’s important to know where you stand in terms of stage so that treatment and follow-up care are tailored appropriately. This post will provide an overview of what each stage looks like so that you can have a clearer idea about which treatments are available to you moving forward in your journey.

What are the stages of cervical cancer?

Doctors assign stages to cancer that range from 0 to 4 depending on the size of the cancer and whether it has spread to other parts of the body. These are based on cervical screenings, scans and biopsies (where they take a section of cells to screen for abnormalities / cancer).

Is cervical cancer curable at stage 1?

In stage 1 the cancer has spread from the cervix lining into the deeper tissue, remaining within the uterus. This is generally curable via small scale surgery such as loop excision, cone biopsy, laser surgery or cryosurgery.  

  • Loop excision: where a hot loop of wire with an electrical current is used to cut away the abnormal tissue. 
  • Cone biopsy: this takes a cone shaped piece of tissue from the cervix. This removes the abnormal cells as well as checking if the cancer has spread beyond the lining of the cervix. 
  • Laser surgery: involves using a long hot beam to cut away sections of abnormal cells. 
  • Cryosurgery: is where a cold metal probe is used to freeze and kill abnormal cells. 

Radiation therapy can also be used which involves high-energy X-rays. There are two methods for this, internal radiation therapy and external beam radiation therapy. In stage 1 usually the latter is used where a machine outside the body directs radiation at the affected areas destroying the cancer cells.

Is stage 2 cervical cancer curable?

Stage 2 cervical cancer is when the cancer is still within the pelvic area but has spread beyond the uterus to nearby areas, such as the vagina or tissue near the cervix.  

This can be cured by surgery depending on the extent of the spread and your age:

  • A trachelectomy involves the surgical removal of the cervix and upper part of the vagina. This surgery preserves fertility and is common in young people. 
  • A total hysterectomy can be performed if the cancer has spread further than this. A total hysterectomy is the surgical removal of the uterus, cervix, soft tissue around the cervix and the top of the vagina (called a radical hysterectomy). 
  • Bilateral salpingectomy is the same but where the fallopian tubes are also removed. 
  • Bilateral salpingo-oophorectomy is where the ovaries are also removed.

Is stage 3 cervical cancer life-threatening?

In stage 3 cervical cancer, the tumour involves the lower third of the vagina. It has spread to the pelvic wall, and caused swelling of the kidney/ affected kidney function, and/or involves regional lymph nodes. 

Lymph nodes are small, bean-shaped organs that help fight infection. The doctor can use an injected dye to identify the lymph nodes closest to the tumour and these can be removed and tested for cancer. This can result in the build up of fluid in the legs, called lymphoedema. 

Stage 3 cervical cancer can be life threatening but can also be curable if the person responds well to treatment. At stage 3 or even at late stage 2 chemotherapy is usually administered and can be in combination with radiation therapy. 

Is stage 4 cervical cancer curable?

Stage 4A cervical cancer is when it has spread to the bladder or rectum. Stage 4B means it has spread to other parts of the body.

For stage 4 cervical cancer, a combination of different chemotherapy drugs are commonly used. Pelvic exenteration surgery can also be performed which involves removing all or part of the affected organs. Openings called a stoma can be made to allow urine and faeces to flow from inside the body to a collection bag. Plastic surgery to reconstruct the vagina can also be offered after pelvic exenteration. 

As well as using different combinations of medicines in chemotherapy, targeted therapy can also be used. Targeted therapy uses medicines that specifically attack cancer cells, affecting how they grow, divide and interact with other cells. These therapies can sometimes cure the cancer or if it is incurable lessen the symptoms.

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References:

Cancer Australia