Cervical cancer is a type of cancer that originates in the cervix, the lower part of the uterus connecting to the vagina. Accurately determining the extent of the cancer, known as staging, guides diagnosis and the development of an effective treatment plan.
Understanding Cervical Cancer Staging
Cancer staging provides a standardized way to describe how much cancer is present in the body and whether it has spread. This classification helps medical teams communicate about the disease, predict its course, and select appropriate therapies. The International Federation of Gynecology and Obstetrics (FIGO) system is widely used globally to stage cervical cancer. This system considers factors such as tumor size, location, and spread to nearby tissues or distant organs.
The FIGO staging system has undergone revisions to incorporate imaging and pathological findings, offering a more precise assessment. While earlier stages typically indicate cancer confined to the cervix, higher stages reflect more extensive disease.
Defining Stage 3 Cervical Cancer
Stage 3 cervical cancer indicates that the disease has spread beyond the cervix to specific regional areas. This stage is further divided into three sub-stages: 3A, 3B, and 3C, each with distinct criteria. These classifications help pinpoint the exact extent of the cancer’s spread within the pelvic region.
In Stage 3A, the cancer has extended to the lower third of the vagina, but it has not reached the pelvic sidewall. This means the cancerous cells are present in the lower vaginal area without involvement of the muscular and bony structures lining the pelvis. Stage 3B is characterized by cancer spread to the pelvic sidewall. Additionally, Stage 3B can also involve hydronephrosis (swelling of a kidney due to urine buildup) or a non-functioning kidney, often caused by the tumor blocking the ureters.
Stage 3C signifies the involvement of lymph nodes, regardless of the tumor’s size or its local extension. This sub-stage is further delineated into 3C1, indicating cancer cells in the pelvic lymph nodes, and 3C2, denoting involvement of the para-aortic lymph nodes near the aorta in the abdomen.
Diagnosing Stage 3 Cervical Cancer
Diagnosing Stage 3 cervical cancer involves a series of tests to determine the cancer’s extent and confirm its spread. A physical examination, including a pelvic exam, is an initial step to assess the cervix and surrounding areas.
Imaging tests are crucial for visualizing the internal spread of the cancer. Magnetic Resonance Imaging (MRI) scans offer detailed images of soft tissues, helping to identify tumor size and invasion into nearby structures like the pelvic sidewall or lower vagina. Computed Tomography (CT) scans and Positron Emission Tomography (PET) scans are also utilized to detect cancer spread to lymph nodes or other distant sites.
Biopsies are fundamental for confirming the presence of cancerous cells and their type. If initial screenings like a Pap test show abnormalities, a colposcopy may be performed to examine the cervix more closely, allowing for targeted biopsies of suspicious areas. In some cases, a cone biopsy, which removes a cone-shaped piece of cervical tissue, may be necessary to obtain a deeper tissue sample for pathological analysis.
Treatment Approaches for Stage 3 Cervical Cancer
Treatment for Stage 3 cervical cancer typically involves a combined approach, primarily utilizing chemoradiation. This integrates chemotherapy with radiation therapy for enhanced effectiveness. The chemotherapy agent commonly used is cisplatin, often administered weekly during the course of radiation therapy.
Radiation therapy for Stage 3 cervical cancer usually includes both external beam radiation therapy (EBRT) and internal radiation therapy, known as brachytherapy. EBRT delivers radiation from a machine outside the body, targeting the pelvic area. Brachytherapy involves placing radioactive sources directly into or near the cervix, providing a concentrated dose of radiation to the tumor.
The goal of this combined treatment is to eliminate cancer cells in the primary tumor and any areas of spread within the pelvis, including affected lymph nodes. In some instances, neoadjuvant chemotherapy, given before chemoradiation, may also be considered to potentially shrink the tumor prior to definitive treatment.