CERVICAL CANCER (con't)
Overview of Cervical Cancer
Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which cells that are not normal begin to appear in the cervical tissue. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas.
Invasive cervical cancer accounts for 6 percent of all gynecologic cancers.
The human papillomavirus (HPV) is the major risk factor for the development of cervical cancer.
Types of Cervical Cancer:
There are several types of cervical cancer, and the treatment may differ by type:
- Squamous cell (epidermoid) comes from the outer
portion of the cervix which protrudes into the vagina. Approximately
80-90% of cervical cancers are squamous cell carcinomas
- Adenocarcinoma comes from cells that make up glands in the cervix. It starts on the more "inner" portion of the cervix, from the same type of cells lining the uterus. Approximately 10% of cervical cancers are adenocarcinoma.
The different subtypes of adenocarcinoma are:
- Endocervical cervical cancer
- Clear cell cervical cancer
- Mucinous adenocarcinoma
- Adenosquamous cervical cancer is a
mixed cell type having features of both squamous cell carcinomas and
adenocarcinomas.
- Glassy cell carcinoma of the cervix is
also called poorly differentiated adenosquamous carcinoma.
- Sarcoma arises from the fat, cartilage, or muscle cells.
Types of cervical sarcoma include:
- Stromal sarcoma
- Embryonal rhabdomyosarcoma
- Sarcoma botryoides
- Leiomyosarcoma
- Lymphoma. Primary cervical lymphoma is rare
with less than 60 cases reported as of 2005. The extent of disease,
size of primary tumor, and type of lymphoma are significant prognostic
features.
- Neuroendocrine cervical cancer is a rare, aggressive tumor which is often under- or misdiagnosed.
Types are:
- Small cell cervical cancer
- Carcinoid tumor
- Melanoma of the cervix. Careful
evaluation is important to determine if the lesion originated in the
cervix, or migrated (metastasized) from elsewhere in the body.
- Adenoid cystic carcinoma of the cervix. Generally presents in the elderly age group and in early-stage.
Stages of Cervical Cancer:
Stage 0
Stage 0 cervical cancer is also known as cervical carcinoma in situ. It is found only in the top layer of cells in the tissue that lines the cervix.
Stage I
Stage I (stage 1) cervical cancer is found only in the cervix. Stage I is divided into stages IA and IB, based on the amount of cancer that is found.
- Stage IA cervical cancer indicates a very small amount of cancer that can only be seen with a microscope is found in the tissues of the cervix. The cancer is not deeper than 5 millimeters and not wider than 7 millimeters.
- Stage IB cervical cancer is still within the cervix and either: can only be seen with a microscope and is deeper than 5 millimeters or wider than 7 millimeters; or can be seen without a microscope and may be larger than 4 centimeters.
Stage II
Stage II (stage 2) cervical cancer extends beyond the cervix into nearby tissues. It extends to the upper part of the vagina. The cancer does not invade the lower third of the vagina or the pelvic wall (the lining of the part of the body between the hips).
- Stage IIA cervical cancer has spread beyond the cervix to the upper two thirds of the vagina but not to tissues around the uterus.
- Stage IIB cervical cancer has spread beyond the cervix to the upper two thirds of the vagina and to the tissues around the uterus.
Stage III
Stage III (stage 3) cervical cancer extends to the lower part of the vagina. It also may have spread to the pelvic wall and nearby lymph nodes.
- Stage IIIA cervical cancer has spread to the lower third of the vagina but not to the pelvic wall.
- Stage IIIB cervical cancer has spread to the pelvic wall and/or the tumor has become large enough to block the ureters (the tubes that connect the kidneys to the bladder). This blockage can cause the kidneys to enlarge or stop working. Cancer cells may also have spread to lymph nodes in the pelvis.
Stage IV
Stage IV (stage 4) cervical cancer has spread to the bladder, rectum, or other parts of the body.
- Stage IVA cervical cancer has spread to the bladder or rectal wall and may have spread to lymph nodes in the pelvis.
- Stage IVB has spread beyond the pelvis and pelvic lymph nodes to other places in the body, such as the abdomen, liver, intestinal tract, or lungs.
Recurrent
Recurrent cervical cancer indicates that the cancer was initially treated but has returned after a period of time during which it could not be detected. The cancer may show up again in the cervix or in other parts of the body
Grades of Cervical Cancer:
Grade indicates how quickly or slowly cancer cells grow. The grade is determined by the appearance of the cells under the microscope. Tumors are graded on a scale of 1 to 3.
Grade 1 - cells look most like normal tissue (called well differentiated). Grade 1 cancers grow and spread somewhat slowly.
Grade 2 - cells look somewhat like normal tissue (called moderately well differentiated). Grade 2 cancers grow and spread quickly.
Grade 3 - cells appear very abnormal (called poorly differentiated or undifferentiated). Grade 3 cancers grow and spread very quickly. They are considered "aggressive."
