ESMO Patients Guide
How will my treatment be determined? Your treatment will depend on the staging of your cancer and risk assessment.
Staging Staging of the cancer is used to describe its size and position and whether it has spread from where it started. For cervical cancer, the system used is called ‘FIGO staging’ and the cancer is staged by assessing tumour size, spread and the presence of any distant metastases (Marth et al. 2017). Staging of cervical cancer may require several investigations, for example: • Examination under anaesthesia: This is a detailed examination of the cervix, vagina, uterus, bladder and rectum under general anaesthetic to check for signs of cancer spread around the cervix. Biopsies are taken from any abnormal areas to check for cancer cells. • Chest x-ray: A chest x-ray is used to check the lungs and chest cavity for any spread of cervical cancer. • Intravenous pyelogram: This is an x-ray of the urinary tract taken after a special dye is injected into a vein. This test can find any abnormal areas in the urinary tract caused by the spread of cervical cancer.
Staging helps to determine the most appropriate treatment for cervical cancer
Other imaging techniques are also available to help with disease staging (increasingly replacing the need for chest x-ray and intravenous pyelogram) and might also be used to help determine the best treatment (Marth et al. 2017) : • Computed tomography (CT) scan: This is a type of ‘three-dimensional x-ray’. The CT scanning machine is large and shaped like a doughnut. Usually the patient lies on the machine couch on their back, and the couch slides backwards and forwards through the hole of the scanner. CT scans can be used to determine the extent of the cancer and may be used instead of chest x-ray and intravenous pyelogram for staging. CT scans can also help to detect if the cancer has spread to lymph nodes (Marth et al. 2017). • Magnetic resonance imaging (MRI) scan: MRI scans use strong magnetic fields and radio waves to produce detailed images of the inside of the body. An MRI scanner is a large tube, similar to a CT scanner, that contains powerful magnets. MRI scans can determine tumour size and spread with high accuracy (Marth et al. 2017).
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