What are the stages of cervical cancer and how is it treated?

Cervical cancer stages are classified from stage I to IV. As a rule, the smaller the number, the less the cancer has spread. A higher number, like stage IV, means the cancer is more advanced. And in a stage, the first letter means the lower stage.

Video content is professionally consulted by BSCKI Nguyen Gia Hoang Anh, Department of Obstetrics and Gynecology, Vinmec Phu Quoc International General Hospital

At this stage, the patient does not have any signs and symptoms, so it is usually only detected through examination and screening for cervical cancer.
Treatment of this stage disease is also relatively simple, with the goal of stopping the progression of the disease to invasive cancer. At this stage, the main treatment measures are cervical cone resection, LEEP excision, partial removal of the cervix or uterus.

Cancer cells have completely localized to the cervix and have grown from the surface of the cervix into the deeper tissues of the cervix. Cancer has not spread to nearby lymph nodes. Cancer has not spread to distant organs. Cervical cancer stage 1 is divided into stages IA and IB with progressive disease progression:

2.1 Stage IA The tumor now has a depth of less than or equal to 5mm and a width of less than or equal to 7mm and can only be diagnosed by microscopy.
Stage IA is further divided into: IA1 (stromal invasion is less than or equal to 3mm deep, width is less than or equal to 7mm), IA2 (stromal invasion is less than or equal to 3mm deep, width is less than or equal to 7mm).
2.2 Stage IB At this stage, cervical or microscopic lesions larger than IA2 have been found at this stage and are divided into IB1 (tumor less than or equal to 4cm), IB2 (tumor larger than 4cm).
Cervical cancer stage 1 is still an early stage, signs of the disease are very rare, so most patients do not know they have the disease without screening tests or uterine examination. Symptoms that may appear during this period include: vaginal bleeding, menstrual cycle changes, strange vaginal discharge color,...
The treatment of this stage depends on your desire to continue having children. The patient's choice for fertility preservation is cone biopsy. Conversely, if you do not want to continue to have children, treatment will be simpler with complete hysterectomy with laparotomy or laparoscopy.
In addition, external radiation therapy combined with internal radiation therapy and chemotherapy may be considered to increase the effectiveness of killing cancer cells.

2.3 Cervical cancer stage 2 This is stage where the cancer has grown beyond the cervix and uterus, but has not spread to the walls of the pelvis or the lower part of the vagina. Has not spread to nearby lymph nodes. Does not spread to distant organs.
Two sub-stages IIA and IIB also assess the degree of invasion of cancer cells getting worse:
Cancer stage IIA: Tumor has spread to 2⁄3 of the vagina but has not invaded the tissues near the cervix. . This stage is divided into IIA1 (tumor less than or equal to 4cm), IIA2 (tumor larger than 4cm). Stage IIB cancer: Cancer cells have now invaded the paracervical tissues but have not invaded the lateral pelvic wall. Treatment for stage 2 disease is also divided into 2 groups according to the need to maintain fertility of the patient. Surgery to remove the cervix and remove the pelvic lymph nodes is the method that allows the patient to resume fertility after treatment. For distant metastatic cancer cells that cannot be removed with surgery, chemotherapy and radiation therapy will be performed in combination.

This is the stage of aggressive disease, the tumor has invaded to the pelvic lateral wall and/or invaded the lower third of the vagina and/or invaded the ureter, resulting in high urinary tract dilatation. Cancer can block the ureter (the tube that carries urine from the kidney to the bladder).
This stage is divided into:
IIIA: the tumor has not invaded to the lateral wall of the subdivision, has invaded to 1/3 of the vagina. IIIB: The tumor has spread to the lateral pelvic wall, possibly to the ureter, thereby leading to hydronephrosis or loss of function.

Stage 4 cervical cancer is stage 4 that has spread into the bladder or rectum or to distant organs such as the lungs or bones.
This stage is divided into IVA (tumor that invades the bladder, possibly invading the rectum) and IVB (tumor that has spread beyond the pelvis). Symptoms of the disease at this time are not only cancer in situ but also secondary cancer symptoms.
If the cancer invades the lung, the common symptoms are difficulty breathing, coughing, coughing up blood,... If the cancer metastasizes to the liver, the patient often has yellow eyes, jaundice, liver pain,... The likelihood of a cure at this stage is very low, combined chemotherapy and radiotherapy will help slow the progression of the disease and reduce pain and improve quality of life.
In order to improve the quality of diagnosis and treatment, Vinmec International General Hospital has applied the ThinPrep Pap Test for early detection of cervical cancer, this new method is now commonly used in the US, Europe. ThinPrep Pap Test has created a turning point compared to the traditional Pap smear method, through membrane controlled cell transfer technology, which increases the sensitivity and specificity in detecting precancerous cells. , especially glandular epithelial cells, a type of cancer cell that is difficult to detect.
At Vinmec, the application of modern methods and procedures to ensure sterility helps to achieve the most accurate results. Screening results are returned to your home with specific advice and recommendations for the patient