Cervical cancer stages are identified with a thorough clinical exam that is performed after a diagnosis is confirmed. Cancer can be staged through a combination of imaging, physical exams, biopsies, tissue diagnoses and sometimes surgery. The results are used to determine the size of any tumors, whether the cancer has invaded tissues in and around the cervix and whether it has spread to other areas of the body. Staging is important because it drives diagnosis, prognosis and treatment.
Cervical cancer stages
Cervical cancer stages are numbered 1 to 4 (“stage 0” is sometimes used to reference abnormal cells that have not grown past the surface layer of the cervix), and are used to describe the cancer’s progression. Stages 1-4 are further broken down with letters (for instance, stage 1A or 1B) based on the size of the cancer. The main stages are described below.
Stage 0 is also commonly called “carcinoma in situ.” This stage is sometimes considered “pre-cancer” because the abnormal cells are only at the surface layer of the cervix and have not moved into deeper layers of cells. When cancerous cells are detected at this early stage, they can be successfully destroyed with proper treatment.
At stage 1, cancer has grown past the surface of the cervix to deeper layers of tissue; it may have moved into the body of the uterus, but it has not progressed outside of the uterus.
When cervical cancer reaches stage 2, it has spread beyond the cervix and uterus, but it has not yet grown to the lower third of the vagina or the pelvic wall. The cancer may or may not have spread to nearby lymph nodes.
Once cervical cancer progresses to stage 3, the cancerous cells have spread to the lower third of the vagina or to the pelvic wall. At this stage, the cancer could cause hydronephrosis (swelling of a kidney) or could be blocking the ureters, which carry urine to the bladder from the kidneys. The cancer may or may not have spread to nearby lymph nodes.
Stage 4 cervical cancer has metastasized to the bladder, rectum or out of the pelvis. It may or may not have spread to the lymph nodes. More advanced stage 4 cervical cancer can spread to distant organs, such as the lungs, liver, bones or distant lymph nodes.
What are the first symptoms of cervical cancer?
Cervical cancer often doesn’t produce noticeable symptoms in its earliest stages. It’s not until tumors begin to form in the cervix and start affecting nearby tissues, lymph nodes and other organs that patients may start to experience symptoms, such as:
- Unusual vaginal discharge that may be watery, blood-tinged or odorous
- Vaginal bleeding between periods or after menopause
- Painful urination
- Vaginal bleeding during sexual intercourse or during a pelvic examination
- Pain during sexual intercourse
- Menstrual periods that are heavier or last longer than usual
- Lower back or pelvic pain
- Swelling of the legs
Many of these symptoms are indicative of other types of conditions, and women who are experiencing them should talk to their physician for further testing.
How long does it take cervical cancer to develop?
Cervical cancer is slow-growing and it can sometimes take several years for the abnormal cells to develop into invasive cancer. Though the average woman who is diagnosed with cervical cancer is in her 50s, it’s not uncommon for physicians to discover precancerous changes of the cervix in women in their 20s and 30s. That’s why undergoing regular Pap smears to detect these abnormalities early is so important. Every woman between the ages of 21 and 65 should undergo routine screenings for cervical cancer. According to the Centers for Disease Control and Prevention (CDC), the guidelines for cervical cancer screening are as follows:
- For women between 21 and 29 years old – You should get a Pap test starting at 21. If your results are normal, you may be able to wait three years for your next Pap smear.
- For women between 30 and 65 years old – You may receive a Pap test only, an HPV test only or both. If you have a normal Pap test, you may be able to wait three years for your next one. If you have a normal HPV test, you may be able to wait five years for your next one. If you receive both tests and both are normal, you may be able to wait five years for your next screening test.
- For women over 65 years old – You may not need to receive a cervical cancer screening if you’ve had normal results for many years or you had a total hysterectomy for a noncancerous condition.
How treatable is cervical cancer?
Like most cancers, when diagnosed in the early stages, cervical cancer is considered to be quite treatable. Surgery is often the first course of action to remove either a portion of the cervix or, for more advanced cancers, the entire cervix along with the uterus and additional organs or tissues. Patients with advanced-stage cervical cancer may also need radiation therapy and/or chemotherapy to destroy any lingering cancer cells.
Moffitt Cancer Center’s approach to cervical cancer treatment
At Moffitt Cancer Center, each patient’s cancer staging is one of many factors that are reviewed in detail during regular tumor board meetings with our cancer specialists. In this way, each patient receives the benefit of multiple expert opinions, all of which are incorporated into a highly individualized treatment plan. At Moffitt, we are proud to provide the very latest in every aspect of cancer care, including screening, diagnosis, treatment and supportive care.
To learn more about cervical cancer stages from the cancer experts at Moffitt, or if you have questions about your prognosis or are in need of diagnostic testing, please call 1-888-663-3488 or complete a new patient registration form. We provide every new patient with rapid access to a cancer expert within a day.