Stages and Grades of Cervical Cancer

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Staging means how big the cancer is and whether it has spread. Grading is determining the extent of abnormality in cancer cells and tissue by examining them under a microscope.

Cervical cancer has four stages, each showing a different level of severity. The classification of each stage is done using the FIGO (International Federation of Gynecology and Obstetrics) staging system.

Stages of Cervical Cancer

The extent of spread determines the stage of cancer. The more advanced the stage, the further the cancer has spread. Cancer caught early with limited spread is more easily treatable and curable compared to later stages characterized by spread to other organs and distant parts of the body.

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Stage 0 The FIGO system does not incorporate this stage. Stage 0 is also known as Carcinoma in situ (CIS). The cancer has grown only in the surface layer of cells lining your cervix. It's not cancer, but a severe precancerous condition. Lack of treatment can result in the transformation into invasive cervical cancer.

Stage 1 indicates cervical cancer limited to the cervix. Stage 1 cervical cancer means the cancer has spread deeper into cervical tissues. This stage is usually symptom-free (asymptomatic). Treatment is usually highly effective for stage 1 cervical cancer. Most treatments for stage 1 disease have no impact on fertility.

The growth in stage 1A is only visible with a microscope or colposcope. It can be split into two smaller groups:

• Stage 1A1 When the cancer growth is under 3 millimeters (mm) into the cervix tissues, it is referred to as Stage 1A1.

• Stage 1A2 Signifies that the cancer has extended 3 to 5 mm into the cervical tissues.

Stage 1B

The cancer in stage 1B is limited to the cervix tissues, with no spread, albeit with larger affected areas. It is visible to the naked eye, but not in every case. There are 3 groups that we can separate it into:

• Stage 1B1 The cancer is larger than 5mm but smaller than 2cm in size.

• Stage 1B2 The size of the cancer in stage 1B2 ranges from 2cm to 4cm.

• Stage 1B3 At stage 1B3, the cancer remains localized in the cervix and measures at least 4cm.

Treatment

The stage of your cancer guides your doctor in selecting the necessary treatment. Treatment also depends on:

• Your cancer type (refers to the specific type of cells that the cancer started in)

• The location of the cancer

• other health conditions that you have

The typical treatment for stage 1 cervical cancer involves: 

• Surgery

• Combined chemotherapy and radiotherapy (chemoradiotherapy)

Stage 2 is identified by regional cancer that has metastasized beyond the cervix and uterus. It hasn't spread to nearby lymph nodes or organs. You might notice symptoms like pelvic pain or bleeding during vaginal sex. Abnormal menstrual bleeding can manifest as spotting between periods or heavier bleeding during menstruation. 

It can be broken down into:

• Stage 2A

• Stage 2B

Stage 2A

In stage 2A, the cancer has extended into the upper area of the vagina. It can be separated into: 

• Stage 2A1 A Stage 2A1 diagnosis indicates the cancer is 4 cm or smaller.

• Stage 2A2 When it reaches stage 2A2, the cancer is greater than 4 cm.

Stage 2B

Stage 2B signifies the spread of cancer into the tissues around the cervix.

Treatment

Your doctor uses the cancer stage to determine the treatment you require.

They also influenced treatment by:

• Your cancer's specific type

• The specific site of the cancer.

• other health conditions that you have

They might address stage 2A cervical cancer with: 

• combined chemotherapy and radiotherapy (chemoradiotherapy) 

• With stage 2A1, surgery may be an additional treatment option.

Chemoradiotherapy is the usual treatment for Stage 2B cervical cancer. 

Stage 3 Cervical cancer has metastasized beyond the cervix into the pelvic walls or the lower part of the vagina.. It may also have spread into nearby lymph nodes. The tumors may adversely affect kidney function if they are large enough. Symptoms may include difficulty urinating, back pain, swollen legs, and blood in the urine.

Stage 4 cervical cancer involves the spread of cancer cells to nearby organs or distant sites, such as the bones, lungs, liver, or brain. Recurrent cervical cancer is part of this stage. Your symptoms in stage 4 will vary depending on the location of metastasis (spread). Fatigue, weakness, and respiratory issues may be part of the symptoms.

https://www.jostrust.org.uk/information/cervical-cancer/grading-staging

https://www.nhs.uk/common-health-questions/operations-tests-and-procedures/what-do-cancer-stages-and-grades-mean/#:~:text=The%20stage%20of%20a%20cancer,how%20far%20it%20has%20progressed.

https://www.verywellhealth.com/is-cervical-cancer-curable-5218955#:~:text=Means%20With%20Cancer-,Stage%20of%20Cervical%20Cancer,distant%20parts%20of%20the%20body.

https://www.cancerresearchuk.org/about-cancer/cervical-cancer/stages-types-grades/stage-1