Staging of cervical cancer

Written by Gong Chun
Oncology
Updated on September 25, 2024
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The clinical staging of cervical cancer mainly uses the FIGO system, which adopts the staging criteria of the International Federation of Gynecology and Obstetrics (FIGO). Staging should be performed before treatment, and once done it does not change after treatment. Since FIGO staging of cervical cancer primarily relies on pelvic examination, it emphasizes the necessity of this examination being conducted by two experienced gynecologic oncologists. If needed, a pelvic examination under anesthesia is performed to ensure the accuracy of the evaluation. So, how is the staging performed? It involves measuring the size of the cervical lesion, particularly the measurement of endophytic tumors, the infiltration of cervical tissue, and the status of pelvic lymph nodes, providing accurate information with the aid of radiological data, especially magnetic resonance imaging (MRI).

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Does cervical cancer hurt?

For patients with cervical cancer, the most common clinical manifestations are bleeding during sexual intercourse and irregular vaginal bleeding. Patients who have undergone menopause may also experience irregular vaginal bleeding post-menopause, and some patients may not show any clinical signs at a very early stage. As the cancer progresses, and when it invades nearby organs and metastasizes, it may cause lower abdominal distension and pain, and even more severe pain if the metastatic organs compress nerves or directly invade areas containing nerves.

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Symptoms of cervical cancer

The most typical early symptom of cervical cancer is usually contact bleeding during intercourse. Clinically, once contact bleeding occurs, it is essential to go to the hospital for cervical cancer screening as soon as possible, generally involving a cervical TCT and HPV test. These two tests can initially screen for the presence of cervical cancer and precancerous lesions. If it has progressed to the stage of cervical cancer, there may be a large amount of vaginal discharge with a foul smell, and severe cases can have symptoms like bleeding and abdominal pain. Therefore, patients with cervical cancer must undergo relevant cervical examinations at the hospital. If it is indeed cervical cancer, treatment options should be selected based on the stage of the disease to treat the symptoms accordingly. Hence, if there is any irregular vaginal bleeding, it is critical to go to the hospital for the relevant cancer screening.

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What are the symptoms of cervical cancer?

The most common symptom of cervical cancer is contact bleeding, which can manifest as bloody vaginal discharge and bleeding after sexual intercourse, as well as intermittent vaginal bleeding outside of menstrual periods. Additionally, it can present with malignant vaginal discharge, increased vaginal secretion accompanied by an unpleasant odor or foul smell, and sometimes purulent discharge. If the cervical cancer tumor spreads to adjacent organs, such as the bladder or kidneys, symptoms may include frequent urination, urinary urgency, back pain, and swelling of the lower limbs. In advanced stages, symptoms can also include anemia, fever, and weight loss.

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How long does it take for cervical cancer to develop?

Cervical cancer generally forms beginning with an infection of human papillomavirus (HPV), and it usually takes five to ten years to develop into cervical cancer. The vast majority of cervical cancer cases are caused by contact with HPV. If this virus continues to replicate in the body, it typically progresses to cervical cancer over a period of five to ten years. Therefore, cervical cancer screening is crucial for women. If regular check-ups are performed annually during this period, it is possible to halt the progression to cervical cancer and its precursors. Cervical cancer screening generally includes routine TCT (ThinPrep Cytologic Test) and HPV testing. These two tests can preliminarily screen for cervical cancer and precancerous conditions. If any abnormalities are detected, it is essential to undergo a colposcopic biopsy at a hospital, as biopsy is the gold standard for diagnosis.

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Causes of cervical cancer

There are several causes of cervical cancer, such as having multiple sexual partners, premature birth, smoking, and early sexual activity, all of which could lead to cervical cancer. However, the main cause of cervical cancer is infection with HPV, the human papillomavirus. It has been scientifically proven that cervical cancer is caused by HPV infection. Therefore, this viral infection is the primary cause of cervical cancer. It is recommended that women of childbearing age undergo cervical cancer screening to check for any abnormalities in the cervix.