Staging refers to the extent and location of abnormal cells. Specific tests are performed to isolate the location and size of the tumor. Most of these tests are imaging tests that help the doctor see inside the body to locate the cancer. Blood and urine tests are performed to see how certain organs are functioning.
The bladder, rectum (lowest part of the large intestine), lungs and lymph nodes are common locations for cervical cancer to spread. The more extensive the disease, the poorer the prognosis.
Colposcopy, which uses a high-intensity light to illuminate the cervix, allows the gynecologist to evaluate the surface of the cervix for abnormalities.
Cystoscopy is a procedure in which a doctor uses a thin, lighted instrument called a cystoscope to examine the urethra and the bladder. The cystoscope also allows the doctor to take a biopsy or tissue sample to determine if cancerous cells are present.
Proctosigmoidoscopy also involves a lighted scope to check the rectum and lower part of the large intestine for the presence of abnormal cells. Proctosigmoidoscopy and cytoscopy are typically performed using local anesthesia, but in some cases may require general anesthesia.
A chest x-ray is used to determine if the cancer has spread to the lungs. An x-ray is also used in conjunction with an intraveneous pyelogram (IVP), which is used to examine the kidneys and bladder. In this procedure a radioactive dye is injected into a blood vessel. The dye highlights the kidneys, ureters and bladder so they are visible on the x-ray film. A barium enema provides a similar highlighting effect of the lower gastrointestinal tract. Liquid barium is introduced into the rectum and large intestine via the anus allowing these areas to be visible on the x-ray film.
Other Imaging Tests
Computed tomography, also called CT or CAT scan, provides detailed pictures of the inside of the body allowing evaluation of enlarged lymph nodes, which are indicative of cancer metastasis. Ultrasound can be used to detect changes in the shape and size of affected organs. Magnetic resonance imaging, or MRI, is a good tool to view images of normal and abnormal changes in soft tissue, as well as the brain, spine and the inside of bones.
Cervical Cancer Prognosis by Stage
Cervical cancer treatments are dependent on the location and staging of the cancer. As the cancer metastasizes to other parts of the body, prognosis drops dramatically because treatment of local lesions is generally more effective than whole body treatments such as chemotherapy.
- Stage I cancer is confined to the cervix and has a 5-year-survival of 80 to 90 percent.
- Stage II cancer extends beyond the cervix and has a 5-year-survival of 50 to 65 percent.
- Stage III cancer extends to the pelvic wall and has a 5-year-survival of 25 to 35 percent.
- Stage IV cancer extends beyond the pelvic area and has a 5-year-survival of 0 to 15 percent.
American Cancer Society. (updated 2003). Detailed guide: Cervical cancer. Retrieved August 14, 2003, from www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt 8.
Fauci, A., Braunwald, E., Isselbacher, K., Wilson, J., Martin, J., Kasper, D., Hauser, S., Longo, D. (ed). Harrison’s Principles of Internal Medicine, 14th Edition. McGraw-Hill, New York, 1998.
Memorial Sloan-Kettering Cancer Center. (2003). Cervical cancer. Retrieved August 26, 2003, from www.mskcc.org/mskcc/html/300.cfm.
National Cancer Institute. (updated 2002). Cervical cancer homepage. Retrieved August 22, 2003, from www.cancer.gov/cancerinfo/types/cervical.