About Cervical Cancer Stage 2

Overview

Stage II cervical cancer refers to cancer that has spread beyond the cervix and has reached the upper two-thirds of the vagina or the tissue around the uterus. In this stage, the cancer is still localized within the pelvic region and has not spread to distant areas of the body.

There are two sub-stages within Stage 2:

• Stage IIA: The cancer has spread from the cervix to the upper two-thirds of the vagina but has not reached the tissue around the uterus. This sub-stage is further divided based on the size of the tumor:
  • Stage IIA1: The tumor measures 4 centimeters or smaller.
  • Stage IIA2: The tumor measures more than 4 centimeters.
• Stage IIB: The cancer has spread from the cervix to the tissue around the uterus.

Determining the stage of cervical cancer is crucial in planning appropriate treatment. It helps healthcare professionals determine the best course of action based on how far the cancer has spread.

Causes and Risk Factors

The cause of cervical cancer is primarily related to persistent Human Papillomavirus (HPV) infection. HPV, specifically types 16 and 18, is the main cause of cervical cancer. However, it's important to note that not all women with HPV infection develop cervical cancer.

Non-modifiable risk factors for cervical cancer include:

• Age: Women between the ages of 30 and 50 are at higher risk.
• Family history: Having a first-degree relative with cervical cancer increases the risk.
• Genetic factors: Certain genetic variations may increase susceptibility to HPV infection and cervical cancer.
• Maternal exposure to diethylstilbestrol (DES): Females born to mothers who took DES during pregnancy are at higher risk of cervical cancer.

Modifiable risk factors for cervical cancer include:

• HPV infection: HPV infection is the most significant risk factor for developing cervical cancer. People more likely to become infected with HPV include those who became sexually active before age 18, have multiple sexual partners, and engage in unprotected sex. The risk of HPV infection can be reduced through vaccination and safe sexual practices.
• Smoking, including second-hand smoke: Increases the risk and progression of cervical cancer.
• Weak immune system: Conditions like HIV/AIDS and immunosuppressive therapy increase susceptibility to HPV infection and cervical cancer.
• Long-term use of oral contraceptives: Using oral contraceptives for an extended period may slightly increase the risk.

Note that these are general risk factors for cervical cancer, not specifically Stage II cervical cancer. It's important to note that these risk factors can vary among individuals, and it's always best to consult with a healthcare professional for personalized advice.

Symptoms

In the early stages of cervical cancer, symptoms may not be noticeable. However, as the cancer progresses to Stage II, the following symptoms may occur:

• Abnormal vaginal bleeding: This can include bleeding after intercourse, bleeding between periods, or bleeding after menopause.
• Pain during sex: Some women may experience pain or discomfort during sexual intercourse.
• Unusual vaginal discharge: This discharge may be watery, strong-smelling, or contain blood.
• Pelvic pain: Women with Stage II cervical cancer may experience pain in the pelvic region.

Symptoms of later stages of cervical cancer, when it has spread beyond the cervix, lower uterus and upper vagina, may include:

• Difficulty urinating
• Blood in the urine
• Swelling in the legs
• Difficulty having bowel movements
• Bleeding from the rectum during a bowel movement
• Persistent, dull backache
• Abdominal pain
• Fatigue

It's important to note that these symptoms can also be caused by conditions other than cervical cancer. If you experience any of these symptoms, it is recommended to consult with a doctor for further evaluation and diagnosis.

Diagnosis

Cervical cancer is first diagnosed, then staged.

To diagnose and determine the stage of cervical cancer, several examinations, tests, and procedures are commonly performed:

• Pap Test: This test collects cells from the surface of the cervix and vagina to check for abnormalities and HPV infection. This is considered a screening test. If abnormalities are identified, further evaluation is performed.
• Pelvic Clinical Examination: This includes inspection and palpation of the pelvic area to assess tumor size, and vaginal and uterine involvement.
• Colposcopy: It involves using a special magnifying device called a colposcope to closely examine the cervix for any abnormal areas.
• Biopsy: A small tissue sample is taken from the cervix during a colposcopy or through a transvaginal needle biopsy guided by ultrasound. The sample is then examined under a microscope to confirm the presence of cancer cells. The tissue sample is sent to lab, where a pathologist will examine it under a microscope.

If cancer cells are found from the cervical biopsy, additional examinations, tests, and procedures are performed to determine the stage.

• Imaging tests: Imaging tests are done to provide detailed views of the inside of the body. Imaging tests help determine the location, size, and depth of the cervical cancer and spread of cancer to other parts of the body. Imaging tests include:
  • Positron emission tomography (PET) scan
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Ultrasound
  • X-rays
• Blood tests: Blood tests may be done to check for signs that cervical cancer has spread to the bladder, kidneys, or liver.
• Examinations of near-by organs may be performed to check for spread of cervical cancer:
  • Cystoscopy: This procedure involves looking inside the bladder
  • Sigmoidoscopy: This procedure involves looking inside the rectum and lower part of the colon. Alternatively, a proctoscopy may be performed to look inside just the rectum.

For stage II cervical cancer, the cervical cancer will have spread to vagina or uterus but will not be found outside the pelvic area.

Remember, these are general descriptions, and specific examinations, tests and procedures may vary based on individual circumstances. It's important to consult with your healthcare professional for personalized advice and guidance.

Treatment Options

The goals of treatment for stage II cervical cancer are to cure the cancer and to prevent its recurrence. The recommended treatments and their mechanisms to achieve these goals are as follows:

• Radiation therapy: This is the preferred treatment for higher stage cervical cancers, including Stage II. It uses high-energy X-rays or other forms of radiation to kill cancer cells and shrink tumors. Radiation therapy can be external beam radiation or internal radiation therapy (brachytherapy). It works by damaging the DNA of cancer cells, preventing them from dividing and growing.
• Chemotherapy: Chemotherapy may be used in combination with radiation therapy for stage II cervical cancer. Chemotherapy drugs are given to kill cancer cells throughout the body. They work by interfering with the cell division process and preventing cancer cells from growing and spreading.
• Surgery: In some cases, surgery may be performed to remove the cervix or uterus. Surgery may also remove lymph nodes in the pelvis. This is typically followed by radiation therapy, which may or may not include chemotherapy. Surgery aims to remove any cancer cells and reduce the risk of recurrence.

Treatment may vary based upon whether a person has stage IIA or IIB cervical cancer, the risk of cancer recurring, and personal factors such desire for future pregnancy. It's important to consult with a healthcare professional specialist to determine the most appropriate treatment plan for individual circumstances.