Overall staging of cervical cancer
After an oncologist has classified cervical cancer according to the TNM system, an overall staging classification is assigned using a designation of 0, I, II, III, IV, based on how advanced the malignancy appears to be. Often, these stages are subdivided, using letters such as IIIA and IIIB, to provide additional information about the size and location of the tumor.
Early stage cancers are the least advanced and often have a better prognosis and likelihood of a cure. Higher stage cancers are often more advanced, but many times they can still be treated successfully, according to the AJCC.
The overall stages of cervical cancer:
Stage 0, also called carcinoma in situ or pre-cancer, is the very earliest stage of cancerous cell changes in the cervix and is highly curable.
- Stage I means cancer is found only in the cervix and often has a good prognosis for treatment and cure. Stage I is divided into stages IA and IB, based on the amount of cancer found and the size of the tumor.
- Stage II cervical cancer has spread beyond the cervix. However, it is not in the pelvic wall or the lower third of the vagina. Stage II cancer is divided into stages IIA and IIB, indicatating how far the cancer has spread. For example, in IIA cervical cancer, the malignancy has spread to the upper part of the vagina but not to tissues around the uterus. Stage IIB means the cancer has spread to tissues around the uterus but isn’t found in the pelvic wall.
- Stage III cervical cancer means the disease has spread to the lower part of the vagina — it may also be on the pelvic wall and causing kidney problems, according to the National Cancer Institute. Stage III is divided into stages IIA and IIB to indicate how far the cancer has spread.
- Stage IV cervical cancer has metastasized to other areas. Stage IVA indicates the malignancy has spread to nearby organs, such as the bladder or rectum, while Stage IVB means the cancer is now found in distant parts of the body, including the liver, lungs, bones, or distant lymph nodes.
Do stages of cervical cancer change?
Once staging for cervical cancer has taken place, the stage of the disease typically does not change over time, even if the cancer progresses, according to the AJCC. Even if a malignancy returns or spreads, it is still referred to by the stage it was given at the original diagnosis.
After a period of remission, doctors may restage a cancer — but very rarely. When restaging of cervical cancer does take place, the same process used during the initial diagnosis is repeated using physical exams, imaging, biopsies, and possibly surgery. However, when a cancer is restaged, the designation is recorded with a lower case "r" before the stage number to indicate the cancer was previously diagnosed and staged.
March 18, 2020
Janet O’Dell, RN