Cervical cancer, one of the most common causes related to deaths by cancer in women, typically originates in the cervix, which is found at the juncture of the vagina and the uterus. The cervix protrudes into the vagina from the bottom most portion of the uterus or the womb.
The good news for millions of women across the world is that, cervical cancer can be prevented by timely intervention, screenings, vaccinations and other important precautions. Pap smear tests and screenings for HPV infections help in the diagnosis of pre cancer that leads to the development of various advanced stages of cervical cancer in sexually active women.
The different stages of cervical cancer take a long time to develop after the symptoms of pre cancer appear. If the development of HPV infection or any pre cancerous cells is detected on the cervix through Pap smear tests and other screening processes, then the development of the advanced stages of cervical cancer can be restricted in the earlier stages.
Various Stages of Cervical Cancer and their Treatment
Stage O or the pre cancer stage
Cervical Intraepithelial Neoplasia (CIN) or cervical pre cancer as it is commonly called, is the stage where the cancerous cells are restricted to the superficial levels of the skin and have not infiltrated into the deeper layers of tissues surrounding the cervix. The preventive measures are usually taken in this stage and this can restrict the advancement of the disease.
Treatment in Stage O
The pre cancerous cells can be treated by local excision, cone biopsy, diathermy, simple hysterectomy or by local excision. The most common methods are cone biopsy or LLETZ ,while simple hysterectomy is used for those patients who have taken the decision of not going in for more children.
The cancerous growth is limited only to the cervix in this stage. This stage of cervical cancer is divided into two sub stages.
Stage 1A reveals the presence of only a very small of abnormal cells which can only be observed under the microscope. Stage 1B or the next sub stage of malignant growth, can be seen with the naked eye and does not require the usage of the microscope.
Treatment in Stage I and early Stage II
Radiotherapy and surgery are the common methods of treatment in these stages. Surgery is often recommended in the younger patients owing to its lesser degree of long term complications. The surgical interventions at this stage are referred to as radical pelvic lymphadenectomy and radical hysterectomy.
The portions that are usually removed through surgery are the uterus, a small portion of the upper vagina, cervix, the parametrium or the tissues surrounding the sides of the cervix and certain nodes or lymph glands from the pelvic region.
If the pathological reports reveal further advancements, then chemotherapy or radiotherapy is used for the treatment of cervical cancer in these stages. As cervical cancer is invasive in nature, the removal of the ovaries may also be done to prevent the advancement of the disease.
In Stage II, the cervical cancer starts spreading slowly into the areas adjoining the cervical region. In the first sub stage, Stage IA, the abnormal cells spread into the upper portions of the vagina occupying over two-thirds of the cervical region.
Stage IIB refers to the stage where the cancer infiltrates into the entire cervix. In this stage the pelvic region remains unaffected by the invasive cancerous growth.
Treatment in Stage IIA and Stage IIB
Radiotherapy was the most common mode of treatment of Stage III cervical cancer in the bygone days. However, of late, chemotherapy is becoming more common and patients usually undergo the same ,for treatment in this advanced stage.
Cervical cancer progressively increases from its earlier stage in Stage III, but remains restricted to the pelvic region. In Stage IIIA, the cancerous cells spread to the lower one third portion of the vagina.
In the next sub stage, which is referred to as Stage IIIB, the cancer advances into the linings and side of the pelvic region, slowly invading the entire pelvis.
Treatment in all stages of Stage III
Chemotherapy and radiotherapy are used for the treatment of cervical cancer patients in these stages. Chemotherapy , according to recent studies, helps in better prognosis and is being increasingly used in Stage III.
This is the most advanced stage of cervical cancer where the abnormal cells spread into several other parts of the body. In Stage IVA, the cervical cancer tends to invade the rectum or the bladder.
Stage IVB, witnesses the spreading of cervical cancer into the areas outside the pelvic region.
Treatment in Stage IV A
The treatment in the most advanced stages of cervical cancer have to be carefully planned and customized according to the specific patients. Some patients are advised surgical intervention, where the uterus and cervix is removed as in the process of radical hysterectomy.
The operation in this stage is known as pelvic exenteration and may also involve the removal of a section of the bowel and the affected bladder along with the cervix and uterus. Radiotherapy and/or chemotherapy may also be used in Stage IVA and IVB.
The Process of “Staging”
“Staging” refers to the process of finding out the extent of invasion of cervical cancer into the other parts of the body. The stage of cervical cancer is determined from the staging process and is helpful in planning the treatment. Some of the procedures used in the staging process are chest X-Ray, CT scan, lymph angiogram, pretreatment surgical training, ultrasound examination, MRI and fine needle aspiration biopsy.
Cervical cancer can be treated if detected in the early stages of the disease. It is important to be aware of the symptoms that arise in the later or the advanced stages of cervical cancer and consult a doctor as soon as they appear.
The treatment and prognosis of cervical cancer is dependent on the stage and the extent of infiltration as mentioned above. Preventive measures should be taken in the pre cancer stage itself to avoid advancement of the disease into the portions other than the cervix.
Photo Credit: http://whatcausescervicalcancer.com/cervical-cancer-stages-and-the-treatments