How staging of cervical cancer is done
Oncologists figure out the stages of cervical cancer by relying on commonly understood medical knowledge about how cancer develops and spreads. Staging of cervical cancer is based on four main factors, according to the American Joint Committee on Cancer (AJCC): the location of the primary (original) tumor, the size of the tumor or tumors, whether the malignancy has spread to nearby lymph nodes, and whether the cancer has spread to distant areas of the 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 fighti infections and other diseases. Lymph nodes also filter substances in the body that move through the 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 the body, so 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 the body for signs the malignancy has metastasized to distant parts of the body.
Laboratory tests of blood, urine, and other fluids and tissues removed from the body provide information on a patient’s health and immune status. In addition to confirming a cancer diagnosis, pathology reports provide information about the type of cancer cells and grade of the tumor (which means how closely the cancer cells resemble normal cells). Pathology reports also can indicate the size of a tumor and its growth into other tissues.
Imagining tests are crucially important in determining the stages of cervical cancer. These tests can show the location of the cancer, the size of the tumor, and whether malignant cells have spread to other areas of the body, according to the National Cancer Institute:
- CT scan (computed tomography scan): Detailed pictures of areas inside the body, taken from different angles, are produced by a computer linked to an x-ray machine. In order to make tissues or organs more visible on the test in order to spot cancer, a dye may be injected into a patient’s 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 the body, this area will “light up” and is imaged 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 the body. The pictures are studied by cancer specialists to see if cancer has spread outside the 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 the abdomen to examine organs inside the abdomen 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 the lungs. However, this form of imaging 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 the bladder and urethra for signs of cancer and remove tissue samples, if needed, to examine under a microscope for cancer.
March 18, 2020
Janet O’Dell, RN