All You Need to Know About Cervical Cancer: Stages & Treatment Options

Cervical cancer is a common type of cancer, with an estimated 13,000 new cases* diagnosed each year in the US. It affects the cervix, the lower part of the uterus that connects to the vagina. It develops when abnormal cells in the cervix grow out of control, leading to a tumor.

The primary cause of cervical cancer is human papillomavirus (HPV), a sexually transmitted infection that often goes away on its own. Women with weakened immune systems, smoking, and a family history of cervical cancer are also at an increased risk of developing the disease. Read our blog post to know more about types of cervical cancer, risk factors and symptoms.

Read our blog post to learn more about the types of cervical cancer, risk factors, and symptoms.   

Stages of Cervical Cancer  

The stages are determined by how far the cancer has spread beyond the cervix. The following are the five stages of cervical cancer:  

1. Stage 0 (Carcinoma in situ)  

At this stage, abnormal cells are only found in the surface layer of the cervix, not in the deeper tissues. This medical condition is also known as pre-cancer and is considered to be the earliest stage. Primary care physicians can detect carcinoma in situ through regular cervical cancer screening tests, such as a Pap smear.

2. Stage I (early-stage cervical cancer)  

At stage I, cancer has already developed in the cervical tissue and may have spread to the uterus or other nearby tissues, but it has not yet affected the lymph nodes or other organs of the body. Stage I is further divided into Stage IA and Stage IB based on the tumor size.  

3. Stage II (locally advanced cervical cancer)  

At this locally advanced stage, cancer has spread beyond the cervix to nearby tissues, such as the vagina, pelvis, or lower part of the ureter. However, it still has not spread to the lymph nodes or other organs. Stage II is further divided into Stage IIA and Stage IIB, based on the extent of the spread.  

4. Stage III (advanced cervical cancer)  

At this stage, the disease has not only spread to the lower third of the vagina, the pelvic wall, or the ureter, but it may also have spread to nearby lymph nodes. However, at stage III, cancer has not yet reached other body parts. Stage III is further divided into Stage IIIA and Stage IIIB, based on the extent of the spread.

5. Stage IV (Metastatic cervical cancer)  

It is the most severe stage as the disease has spread to distant organs, such as the lungs, liver, bones, or distant lymph nodes. Metastatic cervical cancer is the most difficult to treat.

Cervical Cancer Treatment Options  

1. Surgery  

This common surgical procedure involves the removal of cancerous cells and tissues.

• Conization: Surgeons use a scalpel to remove a cone-shaped tissue sample from the cervix and cervix canal. Doctors usually recommend conization to treat pre-cancerous lesions (stage 0) or very early-stage cancer (stage I). This process can be done in the hospital under general anesthesia.  

• Sentinel lymph node biopsy: During this process, the surgeons remove the sentinel lymph node, the first lymph node from where the cancer is likely to spread further. A radioactive substance or blue dye is injected near the tumor to identify it.  

• Hysterectomy: This is another surgical procedure that involves the removal of the uterus and cervix. There are primarily three types of hysterectomy performed in cervical cancer cases.  

During a total hysterectomy, the uterus is removed along with one (unilateral) or both (bilateral) ovaries and fallopian tubes.  

During a radical hysterectomy, the uterus, cervix, part of the vagina, and a wide area of ligaments and tissues around these organs are removed.  

In the case of a modified radical hysterectomy, surgeons remove the tissues surrounding uterus, cervix, upper part of the vagina, and ligaments.   

2. Radiation therapy  

Oncologists often recommend radiation therapy in combination with other treatments such as surgery or chemotherapy. Two types of radiation therapy are used for the treatment of cervical cancer: external beam radiation therapy and brachytherapy. External beam radiation therapy is given from outside the body while brachytherapy involves placing a radioactive source inside the vagina.  

3. Chemotherapy  

This cervical cancer treatment procedure is often used in combination with other treatments such as radiation therapy or surgery to improve the chances of complete recovery. Chemotherapy may be recommended for women with advanced-stage cervical cancer or those whose cancer has spread to other parts of the body.  

4. Targeted therapy  

It is an emerging cancer treatment that works by targeting specific molecules involved in the growth and spread of affected cells. Targeted therapy is often used in combination with other treatments such as chemotherapy or radiation therapy.  

5. Immunotherapy  

In immunotherapy, a person’s immune system fights cancer. Biomarker tests can predict individual responses to certain immunotherapy drugs. Pembrolizumab is a common immunotherapy drug used to treat certain cervical cancers that has a biomarker named PD-L1.  

6. Clinical trials and experimental treatments  

These trials are research studies that test new treatments for cervical cancer. Some women diagnosed with this disease may benefit from experimental treatments available through clinical trials. Women who are interested in participating in a clinical trial should speak with their healthcare provider to learn more about their options. There are a number of cancer centers in Florida that provide detailed information about ongoing clinical trials for cervical cancer.

Follow-up Testing During and After Treatment  

During treatment, doctors may recommend certain tests to monitor the effectiveness of the treatment and they may also decide whether to continue, change, or stop treatment. Periodic follow-up tests or checkups are usually conducted post-treatment to detect any changes in the condition or recurrence of cancer.  

These follow-up tests may be done every 3 to 4 months for the first two years, followed by check-ups every six months. The check-up involves an examination of the body to detect any signs or symptoms of recurrent cervical cancer or late effects of treatment, as well as a current health history review. Depending on the situation, a Pap smear test may or may not be conducted during these visits.  

It is crucial to report any signs or symptoms that may indicate a cancer recurrence. Some common symptoms may include-  

• Vaginal bleeding or abnormal discharge  
• Pain in the abdominal area, back, or leg  
• Swelling in the leg  
• Difficulty during urination  
• Unusual changes in bowel movements  
• Persistent cough or fatigue  

Coping with Cervical Cancer  

Receiving a cervical cancer diagnosis can be challenging and emotional. Individuals should take care of their mental health and seek support from loved ones, as well as from healthcare professionals and support groups. In addition, maintaining a healthy lifestyle, staying informed about treatment and care, and managing stress through meditation or therapy are essential. For any queries or concerns about this disease, contact ACTC, one of the best cancer centers in Florida, and consult our board-certified oncologists. 

*Data retrieved from the Centers for Disease Control and Prevention on the severity of cervical cancer in the US