1. Your cycle
  2. Health
  3. Symptoms and diseases

Flo Fact-Checking Standards

Every piece of content at Flo Health adheres to the highest editorial standards for language, style, and medical accuracy. To learn what we do to deliver the best health and lifestyle insights to you, check out our content review principles.

Stages 3 and 4 Cervical Cancer: Everything About It

The stages of cervical cancer indicate the size of the cancer and whether it has spread or not. Read on to learn what happens during stages 3 and 4 of cervical cancer and how to manage these stages.

Cancer of the cervix is a medical illness in which cancer cells develop in cervical cells. Infection with human papillomavirus is the main thing that increases your risk of developing cervical cancer.

Generally, in the early stages, cervical cancer produces no symptoms or signs, but early detection is still possible with a regular examination and Pap test.

Cervical cancer staging helps describe the location of the cancer and where and if it has spread (metastasized). For cervical cancer, doctors use the staging method established by the International Federation of Obstetrics and Gynecology (FIGO).

FIGO stages for cancer of the cervix

Doctors assess the stages of cervical cancer by examining the tumor or lump and determining whether it has spread to other areas of the body.

Doctors use physical examinations, biopsies, and imaging scans to assess the stage of cervical cancer.

Stage I — In this stage, cervical cancer has spread from the lining of the cervix into the deeper tissues; however, it is still contained in the uterus and hasn’t spread to other areas of the body.

Doctors assess the stages of cervical cancer by examining the tumor or lump and determining whether it has spread to other areas of the body.

Stage II — In this stage, the cancer has spread outside the uterus to nearby regions in the cervix or the vagina, but it is still only inside the pelvis.

Stage III — In this stage, the lump or tumor is in the lower third of the vaginal region and/or has spread to the wall of the pelvis. It may be causing kidney swelling (hydronephrosis) or stopped the functioning of the kidney. It might also have spread to the regional lymph nodes. Cancer at this stage will not have spread to distant body parts.

Stage IVA: In this stage, the cancer has spread to the rectum or bladder but no other areas of the body.

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

In stage 3 cervical cancer, the cancer has spread to the lower third of the vagina and/or to the wall of the pelvis. It may also be causing kidney problems and have spread to nearby lymph nodes. 

Stage 3 cervical cancer is further subdivided into the following stages:

Stage IIIA: In this stage, the cancer has spread to the lower third of the vagina but doesn’t involve the wall of the pelvis.

In stage 3 cervical cancer, the cancer has spread to the lower third of the vagina and/or to the wall of the pelvis.

Stage IIIB: In stage 3B cervical cancer, the cancer has spread to the wall of the pelvis. The lump may be so large that it blocks one or both of the tubes that carry urine from the kidney (ureters), enlarges one or both kidneys, or stops kidney function altogether.

Stage IIIC: This stage is further subdivided into two stages based on the involvement of the lymph nodes.

In stage IIIC1, the cancer has spread to lymph nodes in the pelvis.

In stage IIIC2, the cancer has spread to lymph nodes in the abdominal region.

In stage 4 cervical cancer, the cancer has spread outside the pelvis to the rectum, bladder, or other areas of the body.

Stage 4 cervical cancer is further subdivided into the following stages:

Stage IVA: In this stage, the cancer has spread to nearby organs such as the rectum or bladder.

In stage 4 cervical cancer, the cancer has spread outside the pelvis to the rectum, bladder, or other areas of the body.

Stage IVB: In stage 4B cervical cancer, the cancer has spread to other areas such as the lungs, bones, liver, or other lymph nodes.

Women with metastatic and advanced cervical cancer may develop severe symptoms, depending on the organs and tissues affected.

Some of the symptoms and signs of cancer of the cervix are as follows:

  • Light bleeding or spotting following or between periods
  • Heavier and longer periods than usual
  • Increased vaginal discharge 
  • Bleeding after sex, a pelvic examination, or douching
  • Pain during sex
  • Unexplained and persistent back and/or pelvic pain 
  • Vaginal bleeding after menopause

To treat stage 3 and 4A cervical cancer, the oncologist may try the following:

  • Simultaneous chemotherapy and radiation therapy
  • Surgical removal of lymph nodes in the pelvis followed by radiation therapy. They may also prescribe chemotherapy.
  • Internal radiation therapy
  • A clinical trial of chemotherapy to reduce the size of the tumor, followed by surgical removal of the tumor
  • A clinical trial of simultaneous radiation therapy and chemotherapy, followed by chemotherapy

To treat stage 4B cervical cancer, the oncologist may try the following:

  • Radiation therapy to relieve stage 4 cervical cancer symptoms and improve quality of life
  • Chemotherapy along with targeted therapy
  • Chemotherapy to relieve stage 4 cervical cancer symptoms and improve quality of life
  • Clinical trials of new anticancer drug combinations

Radiation therapy is a type of cancer treatment that utilizes high-energy X-rays or other kinds of radiation to destroy cancer cells. There are two types of radiation therapy:

  • In external radiation therapy, the doctor places a machine outside the body that sends radiation in the direction of the cancer.
  • In internal radiation therapy, the doctor places a radioactive material sealed inside a delivery mechanism (e.g., “seeds,” wires, catheters, or needles) near or directly into the cancer tissue.

Chemotherapy is a type of cancer treatment that uses drugs or medicines to stop the cancer cells from growing. The doctor may give the drugs either by mouth or inject them into a muscle or vein.

Targeted therapy is a kind of cancer treatment that uses drugs or other substances to pick out and attack cancer cells to destroy them without causing any harm to the normal healthy cells.

A team of health care professionals will guide you through the planning process before external radiation therapy. This is to make sure that the radiation hits the exact right spot. Planning generally includes the following:

  • Radiation simulation is when the team helps you find a comfortable position for the duration of the treatment. You have to lie still during the treatment, so finding a position where you can be comfortable for a while is helpful. Doctors may use restraints and cushions to help you lie still in the correct position. The team will mark the area of the body that needs the radiation with a temporary marker or tiny permanent tattoos.
  • During planning scans, the team will conduct computerized tomography scans to precisely find the area of the body that needs treatment.

Once the planning is over, the team makes a decision about the kind and dose of radiation you need depending on the stage of the cancer and its type, your overall health, and your treatment goals.

Planning for chemotherapy is based on which medicines you will get and how you’ll take them. Chemotherapy planning may consist of the following:

  • If you are receiving chemotherapy into a vein (intravenously), then you may get a device such as a port, pump, or catheter surgically inserted into a large vein. This is usually done in the chest.
  • You may have to undergo procedures and tests to make sure that your body is ready for chemotherapy.
  • You may need a dental checkup to check for any existing infections. Treating such infections can decrease your risk of developing complications during chemotherapy.
  • You may want to plan for adverse effects. For example, if the side effects of your chemotherapy will be hair loss, you can plan for that in advance.
  • You can make arrangements at work and for pets, children, and other commitments depending on how chemotherapy may affect your daily activities.
  • Ask your doctor about how to prepare for your first chemotherapy treatment. You might be able to eat a light snack before getting treatment in case the drugs cause nausea. Consider having a family member or friend drive you to the first treatment session, as the side effects may make it difficult to drive home.

In cervical cancer stage 3, the cancer has spread to the lower portion of the vagina and/or the wall of the pelvis. It might be causing kidney problems and have spread to nearby lymph nodes. In cervical cancer stage 4, cancer has spread outside the pelvis to the bladder, rectal lining, or other areas of the body. Treatment for stage 3 or 4 cervical cancer depends upon how or if it has spread, its location, and your overall health condition. Your team of health care professionals will develop a treatment plan based on your condition and needs.

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

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

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

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

Read this next