If you have been diagnosed with cervical cancer, your consultant will order more tests (including biopsies, MRIs, PET scans, CT scans and ultrasounds). These tests will help them to find out what type of cervical cancer you have (name), how different the cancer cells look compared with the normal cells (grade), and the extent that the cancer has progressed and if the cancer cells have spread to other parts of the body (stage).
- Squamous cell – eight out of ten (80%) cervical cancers are diagnosed as squamous cell. Squamous cell cancers are composed of the flat cells that cover the surface of the cervix and often begin where the outer surface joins with the cervical canal.
- Adenocarcinoma – more than one in ten (15–20%) cervical cancers are diagnosed as adenocarcinoma. This cancer develops in the glandular cells which line the cervical canal. This type of cancer can be more difficult to detect with cervical screening tests because it develops within the cervical canal.
Adenosquamous cancers are tumours that contain both squamous and glandular cancer cells. Other rare types of cervical cancer can include clear cell, small cell neuroendocrine carcinomas, lymphomas and sarcomas.
Tumour grading helps the doctor predict how cells may behave. Cells are graded from 1 to 3 depending on how different they look to normal cells under the microscope. Grade 1 tumours tend to be slow growing and don’t look as abnormal as higher grade tumours.
You may be asked to have various diagnostic tests that will help your health care professionals understand your cancer better. These could include: a pelvic examination, an MRI or PET-CT scan, a chest x-ray or blood tests. Your consultant needs information to understand the shape and position of your cancer in relation to the organs within your pelvis, and if the cancer cells have spread to other parts of the body. This process is called staging. Knowing the stage of the disease helps your consultant and the rest of your team to plan your treatment. The presence of cancer in the lymph nodes does not alter the way cervical cancer is staged, but it may change the way the cancer is treated.
Carcinoma of the cervix: staging cervical cancer (primary tumour and metastases)
The following stages are used to describe cancer of the cervix:
- Stage 1a: Cancer involves the cervix but has not spread to nearby tissue. A very small amount of cancer that is only visible under a microscope is found deeper in the tissues of the cervix
- Stage 1b: Cancer involves the cervix but has not spread nearby. A larger amount of cancer is found in the tissues of the cervix
- Stage 2a: Cancer has spread to nearby areas, but is still inside the pelvic area. Cancer has spread beyond the cervix to the upper two thirds of the vagina.
- Stage 2b: Cancer has spread to nearby areas, but is still inside the pelvic area. Cancer has spread to the tissue around the cervix
- Stage 3: Cancer has spread throughout the pelvic area. Cancer cells may have spread to the lower part of the vagina. The cells also may have spread to block the tubes that connect the kidneys to the bladder (the ureters)
- Stage 4a: Cancer has spread to other parts of the body, such as the bladder or rectum (organs close to the cervix)
- Stage 4b: Cancer has spread to distant organs, such as the lungs (organs far away from the cervix).