Cervical Cancer Stages — Page 2

How staging of cervical cancer is done

Oncologists rely on commonly understood medical knowledge about how cancer develops and spreads to figure out the stages of cervical cancer. Staging is based on four main factors:

• The location of the primary (original) tumor
• The size of the tumor or tumors
• Whether the malignancy has spread to nearby lymph nodes
• Whether the cancer has spread to distant areas of your body

To collect information to determine stages of cervical cancer, doctors use a variety of tests.

A physical examination is an initial part of the staging of cervical cancer. The exam may reveal clues about the size of a tumor and whether lymph nodes are enlarged and need to be biopsied. Lymph nodes, small bean-shaped structures, are part of the body’s immune system and contain white blood cells that help fight infections and other diseases. Lymph nodes also filter substances in your body that move through lymphatic fluid.

Many types of cancers, including cervical cancer, are likely to spread to nearby lymph nodes before the malignancy metastasizes to other parts of your body. Determining if cancer has spread to any lymph nodes is an important part of the staging of cervical cancer, along with checking the rest of your body for signs of metastasis.

Laboratory tests of blood, urine, and other fluids and tissues provide information on your health and immune status. In addition to confirming a diagnosis, pathology reports provide information about the type of cancer cells and grade of the tumor (how closely the cancer cells resemble normal cells). Pathology reports also can indicate the size of a tumor and the extent of its growth into other tissues.

Imagining tests are important in determining the stages of cervical cancer. These tests can show the location of cancer, the size of the tumor, and whether malignant cells have spread to other areas of your body:

• CT scan (computed tomography scan). A computer linked to an x-ray machine produces detailed pictures of areas inside your body. To make tissues or organs more visible on the test, a dye may be injected into your vein or taken orally.
• PET scan (positron emission tomography scan). Cancer cells take up more glucose (sugar) than normal cells, so a small amount of radioactive glucose is injected into a vein for this test. If cancerous cells have spread from the cervix to another part of your body, this area will “light up” during the scan.
• MRI (magnetic resonance imaging). MRIs use technology that combines a magnet, radio waves, and a computer to make detailed pictures of areas inside your body. Cancer specialists study the pictures to see if cancer has spread outside your cervix.
• Ultrasound exam. High-energy sound waves (ultrasound) are bounced off internal tissues or organs, creating echoes that form a picture of body tissues so they can be examined for signs of cancer.
• Laparoscopy. This minimally invasive surgical procedure uses a laparoscope (a thin, lighted tube) inserted through small incisions in the wall of your abdomen to examine organs for signs of cancer. Tissue samples may be taken to be studied under a microscope, too.
• Chest x-ray. A chest x-ray may be used to see if cancer has spread to your lungs. It is rarely used for staging of cervical cancer unless the cancer is far advanced, according to the American Cancer Society.
• Cystoscopy. A doctor can use a thin, tube-like instrument with a light and a lens (a cystoscope) to look inside your bladder and urethra for signs of cancer and remove tissue samples, if needed, to look for cancer under a microscope.

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