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Understanding Your Stage of Cervical Cancer

Stage is the word doctors use to classify the size of a cancerous tumor and where it is located. The first place cancer is found in the body is called the primary site or primary tumor. When a cancer spreads, it's said to have metastasized.

How cervical cancer spreads

Cervical cancer can start growing in other parts of the body and spread in 2 main ways: 

  • It may grow larger and directly invade nearby structures such as the vagina, bladder, rectum, or other tissues near the uterus and vagina.

  • It may spread through the lymph nodes in the pelvis.

A third type of spread, through the bloodstream, is uncommon.

When cervical cancer has spread to another part of the body, it's not considered a new cancer. For example, if it spreads to the vagina, it's not called vaginal cancer. It's called cervical cancer with vaginal involvement. This is because cancer is usually named for the site of the original tumor.

Stage groupings of cervical cancer

The most commonly used staging system for cervical cancer is a system developed by the International Federation of Gynecology and Obstetrics (FIGO). In this system, the Roman numerals from 0 to IV represent the different stages of the cancer. The higher the number, the more serious or advanced the cancer is.

Stage 0 (this stage is not included in the FIGO system) 

This stage is also called carcinoma in situ (CIS). The tumor is still very superficial. It has grown only in the layer of cells lining your cervix.

Stage I

This cancer has grown into your cervix. It has not spread elsewhere. Stage I is further divided into these groups:

  • Stage IA1. The doctor cannot see this cancer without a microscope. It is less than 3 mm deep and less than 7 mm wide.

  • Stage IA2. The doctor cannot see this cancer without a microscope. It is between 3 and 5 mm deep but still less than 7 mm wide.

  • Stage IB1. The tumor may be microscopic or may be visible to the doctor. It is a tumor less than 4 cm in size and confined to the cervix. 

  • Stage IB2. A doctor can see this cancer with the naked eye. It is larger than 4 cm in size.

Stage II

This cancer is in body parts near your cervix but not outside your pelvis or to the lower part of your vagina. Stage II is further divided in these ways:

  • Stage IIA. This cancer can be seen and may extend to your upper vagina. It has not spread into the tissues deeper than the vagina.

  • Stage IIB. This cancer has spread to the tissues surrounding your vagina and cervix but not yet to the wall of the pelvis.

Stage III

This cancer has spread to your lower vagina or to the wall of the pelvis. Stage III is further divided in these ways:

  • Stage IIIA. The cancer has spread to the lower third of your vagina. It has not spread to the wall of your pelvis.

  • Stage IIIB. The cancer has spread to the soft tissues surrounding your vagina and cervix all the way to the wall of the pelvis. It may cause blockage of urine flow to your bladder. It may have spread to lymph nodes in the pelvis, but it has not spread to distant parts of your body. 

Stage IV

With this stage, the cancer has spread to other parts of your body, such as your bladder, rectum, or lungs. Stage IV is further divided in these ways:

  • Stage IVA. The cancer has spread to nearby organs, such as your bladder or rectum.

  • Stage IVB. The cancer has spread to distant organs beyond your pelvis, such as your lungs.

Doctors consider the stage of the cancer, knowledge of a woman's overall health, and the woman's feelings and preferences when recommending a treatment plan. Staging information helps doctors compare an individual situation to other women with cervical cancer. Based on clinical studies done on groups of women in similar stages of the cancer, a doctor can make some predictions about how the cancer may behave, and how different kinds of treatment may work.