As with any type of cancer, cervical cancer is so named for the part of the body in which it begins. Staging is important for a cervical cancer diagnosis because it helps the patient’s medical team determine appropriate treatment courses, prognosis, and other important information. Here’s a look at understanding how cervical cancer is staged.
TMN and FIGO Systems of Staging
When cancer is diagnosed, the current stage is determined using the TNM system, as designed by the American Joint Committee on Cancer (AJCC). This means examining the size of the tumor (T), if the lymph nodes have developed cancer (N), and whether the cancer has metastasized (or spread) to other parts of the body (M). The stage of cancer at the time of diagnosis remains throughout treatment; even if the stage “changes” the diagnosis remains the same, while adding additional information.
However, since cervical cancer is a type of gynecological cancer, the International Federation of Gynecology and Obstetrics (FIGO) system may be utilized instead of or in addition to the AJCC’s TMN system.
TMN System Specifics
The AJCc’s TMN system rates the overall stage of cancer as 0, I, II, III, or IV. To choose the overall stage, tumor, lymph nodes, and metastasis are each staged individually as well. According to the American Cancer Society, the extent of the tumor starts as “Tis,” at which point the cancerous cells are only on the top layer of the cervix.
As the cancer burrows deeper into the tissue, the T-stage increases. For example, at “T1” the cancer has begun to spread into the uterus but has not gone any farther. T2 indicates the cancer is in the cervix, uterus, and upper vagina, but not the pelvis or lower vagina. T3 means the cancer has reached the pelvic walls and/or lower vagina, while at T4 the cancer is in the bladder, rectum, or outside of the pelvis.
Additional labelings of a1, a2, b1, or b2 indicate the visibility and size of the tumor. The lymph nodes are labeled as NX, N1, or N0: the nearby lymph nodes are unassessable, have not become cancerous, or have become cancerous, respectively. M0 denotes no metastasizing, while M1 indicates spreading to distant lymph nodes, organs, or tissues.
FIGO Differences from the TMN System
Essentially, the same information is used in the FIGO system, only in a slightly different way. The biggest difference is that there is no 0 stage in the FIGO system, and the lymph nodes are included later. Otherwise, both systems utilize the information obtained from the tumor, lymph nodes, and metastasis to determine the overall stage, with I being the least aggressive and IV being the most aggressive.
