Overview of Cervical Cancer Stages and Their Treatment

Cervical cancer is a type of malignancy that occurs in women. Women at higher risk for cancer of the uterine cervix are those who begin sexual intercourse at an early stage, those who have multiple sex partners, history of multiple pregnancies, develop cervical dysplasia or sexual relations with high risk males. Studies suggest that during adolescence, cervical epithelial cells are particularly sensitive to carcinogenic change.

Cervical cancer is classified and treated according to four cervical cancer stages of differentiation. Stage one is characterized as growth limited only to the cervix. When growth extends beyond the cervix, it is already considered as stage two. It is classified as stage three once the growth has extended into the pelvic wall. Lastly, if the growth has extended to adjacent organs then it has already reached the fourth stage.

Patients with cancer of the cervix may present with symptomatic or asymptomatic disease. Symptoms indicative of early stages of cervical cancer are prolonged menstrual periods, watery vaginal discharge and slight intermenstrual vaginal bleeding after coitus, travel or exertion. These findings may be present for months before additional irregularities occur. As the lesion becomes more extensive, symptoms are more pronounced. Hemorrhage occurs with advanced infiltrative tumors.

The first symptoms produced by the tumor after menopause is usually alarming because they are unexpected. Consequently the patient usually promptly seeks attention. However, if the symptoms begin two to three years after menopause, the patient may think that menstruation has resumed and will delay seeking medical attention.

In later stages, a serosanguinous or yellowish vaginal discharge may be present. It is often foul-smelling due to the sloughing of epithelium and may be associated with profuse bleeding. Pain in the lumbosacral area is usually a late sign and occurs with lymph node involvement. Urinary and rectal symptoms may appear when advanced local disease has invaded the bladder and rectum.

Treatment of cervical cancer is determined by the clinical findings, stage of disease, overall condition of the patient, and whether she wishes to preserve the reproductive mechanism. The treatment of preinvasive lesions can consist of cryotherapy, electrocautery, laser therapy, or conization. For the first level of cervical cancer stages, carcinoma can be conservatively managed by cervical conization, vaginal radiation therapy, and laser treatment. Patients who are conservatively managed should be closely evaluated at least yearly for further appearance of cancer.

Either surgery or radiation therapy are used for stages 1 and 2. Radiation therapy may be used alone for stages 2 and 3. For stage 4, pelvic exenteration may be performed. In advanced tumors in stages 3 and 4, external radiation therapy may be beneficial. External, internal and interstitial radiation therapy may be used. Systemic chemotherapeutics or regional chemotherapeutics are also treatments for cervical cancer.

The earlier the stage at which cancer is diagnosed means a better the prognosis. Preinvasive cancer commonly is diagnosed in women 30 to 40 years of age. Most patients with invasive carcinoma are 40 to 50 years old. Thus, 5 to 10 years are required for the chance to penetrate the basement membrane and become invasive. After invasion, death usually occurs in 3 to 5 years in the untreated patient. That is why to prevent any complications, watch out for early signs of cervical cancer.