Engaging Staging Messaging: A Case Study

Staging Staging is clinical based on pelvic examination and may include an intravenous pyelogram (IVP),
Stage 0: Carcinoma in-situ (CIS). The basement membrane is intact.
Stage 1: Spread limited to the cervix. This is the most common stage at diagnosis.
Ia1: Invasion is ≤3 mm deep (minimally invasive)
Ia2: Invasion is >3 but ≤5 mm deep (microinvasion)
IB: Invasion is >5 mm deep (frank invasion)
Stage II: Spread adjacent to the cervix IIa: Involves upper two thirds of vagina IIb: Invasion of the parametria
Stage III: Spread further from the cervix IIIA: Involves lower one third of vagina IIIB: Extends to pelvic side wall or hydronephrosis
Stage IV: Spread furthest from the cervix IVA: Involves bladder or rectum or beyond true pelvis IVB:
Patients treated surgically are elevated for risk factors for metastatic disease and tumor recurrence. These include metastatic disease to the lymph nodes, tumor size >4 cm, poorly differentiated lesions, or positive, margins. Patients with these findings are offered adjuvant therapy (radiation therapy and chemotherapy).
• Specific by stage:
Stage Ia1: Total simple hysterectomy, either vaginal or abdominal
Stage Ia2: Modified radical hysterectomy
Stage IB or IIA: either radical hysterectomy with pelvic and paraaortic hymphadenectomy (if premenopausal) and peritoneal washings or pelvic washings or pelvic radiation (if postmenopausal). In patients who can tolerate surgery, a radical hysterectomy is preferred; however, studies have demonstrated equal cure rates with radiation or surgical treatment.
Stage IIB , or IV: Radiation therapy and chemotherapy for all ages.
Follow-up. All Patients with invasive cervical cancer should be followed up with Pap smear every 3 months for 2 years after treatment, and then every 6 months for the subsequent 3 years.
• Patients who have a local recurrence can be treated with radiation therapy; if they had received radiation previously, they might be considered candidates for a pelvic