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Stage 2 Cervical Cancer: All About It

A doctor may diagnose stage 2 cervical cancer if the cancer has extended beyond the cervix into surrounding tissues. Read on to learn more about this stage of cervical cancer and how to manage it.

Cervical cancer is when cancer (malignant) cells develop in cervical tissues. Infection with human papillomavirus is one of the main things that can increase your risk of developing cervical cancer. Although there are typically no symptoms or signs in the early stages of cervical cancer, it may cause pelvic pain and/or vaginal bleeding in later stages.

To determine the severity of cancer of the cervix, professionals use the staging system established by the International Federation of Obstetrics and Gynecology (FIGO). According to FIGO, these are the stages of cervical cancer:

Stage 1 — In this stage, the cancer has spread (metastasized) from the cervical lining into the deep cervical tissues; however, is still contained in the uterus.

Stage 2 — In cervical cancer stage 2, the cancer has spread outside the uterus to nearby regions, such as the tissues surrounding the cervix or the vagina. At this stage, the cancer remains inside the pelvis and hasn’t spread to other areas of the body.

Stage 3 — In this stage, the cancer has spread to the lower portion of the vagina and/or the wall of the pelvis. It may cause kidney swelling (hydronephrosis) or stop the functioning of a kidney. It may also have spread to nearby lymph nodes.

Stage 4A: In this stage, the cancer has spread to the rectum or bladder, but it hasn’t spread to other areas of the body.

Stage 4B: In this stage, the cancer has spread to other areas of the body.

In cervical cancer stage 2, the cancer starts spreading outside the cervix into surrounding tissues. It doesn’t spread into the ligaments or muscles lining the pelvis or in the lower portion of the vagina.

Stage 2 cervical cancer is further divided into the following stages:

Stage 2A — In this stage, the cancer has spread into the upper portion of the vagina. Stage 2A may be further divided into:

Stage 2A1 — In this stage, the cancer is four centimeters or less.

Stage 2A2 — In this stage, the cancer is more than four centimeters. 

Stage 2B — In stage 2B cervical cancer, the cancer has spread outside the uterus and cervix into surrounding tissues. The cancer hasn’t spread to the pelvic walls or the lower portion of the vagina.

Some people with early-stage cancer of the cervix experience some symptoms. Some of the symptoms or signs of stage 2 cervical cancer are:

  • Spotting or light bleeding following or between periods
  • Heavier and longer periods than normal
  • Vaginal bleeding after having sex, a pelvic exam, or douching
  • Increased vaginal discharge 
  • Pain during sex
  • Vaginal bleeding after menopause
  • Unexplained and continuous back and/or pelvic pain 

Some of the stage 2 cervical cancer treatment options are as follows:

Chemoradiation

One of the main stage 2 cervical cancer treatment options is chemoradiation. In this treatment, your doctor will give you chemotherapy along with radiation therapy to increase the effectiveness of the radiation therapy. You may get chemoradiation after undergoing surgery for stage 2 cervical cancer.

The drugs that are given during chemotherapy are cisplatin plus 5-fluorouracil or cisplatin.

Surgery

Your doctor may recommend surgery to treat cervical cancer stage 2. The kind of surgery may depend on various factors such as the stage of cancer, your age, and whether you want a baby in the future or not.

Radical hysterectomy

Your doctor may do a radical hysterectomy, remove pelvic lymph nodes, and sample the lymph nodes in the back of your abdomen. A hysterectomy removes your uterus, so you will not be able to get pregnant after this procedure. You may need chemoradiation or radiation therapy after a radical hysterectomy.

Dissection of lymph nodes

Your doctor may do a dissection of lymph nodes to treat stage 2 cervical cancer. This procedure involves removing the lymph nodes in the pelvis and is followed by either radiation therapy or chemoradiation.

Radiation therapy

Your doctor may use radiation therapy as the main form of stage 2 cervical cancer treatment if you can’t or don’t want to undergo surgery. They may also use radiation therapy after surgery if there are cancer cells in or near the removed tissue or in the lymph nodes, lymphatic vessels, or blood vessels of the removed tissue.

You may be given external radiation therapy either by itself or along with intracavitary brachytherapy (a kind of internal radiation therapy) to treat cervical cancer stage 2. In most cases, radiation therapy is given along with chemotherapy, but in certain cases, doctors may give it without chemotherapy.

Generally, radiation therapy is given five days a week for six to seven weeks.

  • Before undergoing surgery, gather information about the procedure. Learning about it may make you more confident about your decision to undergo surgery and also make you more comfortable.
  • Always follow your doctor’s instructions about medication. Tell them about all the medications you are taking, including any dietary supplements, over-the-counter medicines, and herbal preparations.
  • Talk to your doctor about the kind of anesthesia they may give you during the surgery.
  • Plan for your hospital stay. You may have to stay for one or two days if you are having an abdominal hysterectomy.
  • Full recovery from surgery may take a few weeks. During that your recovery time, the doctor may tell you to restrict your activities and avoid lifting heavy objects or driving. Ask for help if you think you might need it.

Planning for radiation therapy includes the following:

  • Radiation simulation — Your healthcare team will help you find a comfortable position to stay in during treatment. It is important to lie still during the treatment, so finding a comfortable position is key. During the simulation, you will lie down on a table similar to the one that your doctor will use during the radiation therapy. They may use restraints and cushions to help you stay in the position. They will put a mark on your body (either with a temporary marker or tiny permanent tattoos) where you need the radiation. 
  • Planning scans — Your healthcare team will use computerized tomography scans to help find the region of the body that needs treatment.

After planning for radiation therapy, your healthcare team will decide on the kind and dose of radiation you will get based on the stage and type of cervical cancer. It also depends on your overall health and treatment goals.

Preparing for chemotherapy is based on the drugs or medicines you will get and how you will take them. Planning for chemotherapy for cervical cancer stage 2 includes the following:

  • Your doctor may surgically insert a device (for example, a pump, port, or catheter) into a large vein, usually in your chest. Chemotherapy medicines are then administered through this device.
  • You may have to undergo tests looking at your heart and blood to ensure that your body can receive chemotherapy.
  • You may get a dental check-up to rule out any existing infections. Treating any infections may decrease your risk of complications during chemotherapy.
  • Make plans to deal with the side effects of chemotherapy. For example, if your chemotherapy will lead to infertility, you can consider preserving your eggs.
  • Make appropriate arrangements for children, work, or other commitments, as chemotherapy may affect your general activities.
  • Prepare for the first chemotherapy treatment. Come to the clinic well-rested or after eating a small meal. The chemotherapy drugs may cause nausea. Ask a family member or a friend to drive you to the first treatment session because chemotherapy medicines may make you sleepy.

In cervical cancer stage 2, the cancer starts spreading outside the cervix to the nearby tissues. The cancer hasn’t spread into the ligaments or muscles lining the pelvis or the lower portion of your vagina. Stage 2 cervical cancer can be further divided into stage 2A and stage 2B. You and your doctor can decide on the best treatment for you based on the stage of cervical cancer, its location, type, and other associated health conditions.

https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq

https://www.cancer.net/cancer-types/cervical-cancer/stages

https://www.cancer.ca/en/cancer-information/cancer-type/cervical/staging/?region=on

https://www.cancerresearchuk.org/about-cancer/cervical-cancer/stages-types-grades/stage-2

https://www.cancer.net/cancer-types/cervical-cancer/symptoms-and-signs

https://www.mayoclinic.org/tests-procedures/abdominal-hysterectomy/about/pac-20384559

https://www.mayoclinic.org/tests-procedures/radiation-therapy/about/pac-20385162

https://www.mayoclinic.org/tests-procedures/chemotherapy/about/pac-20385033

https://www.cancerresearchuk.org/about-cancer/cervical-cancer/stages-types-grades/stage-4

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