Once cancer cells have been identified to invade the tissue beneath the epithelial surface lining of the cervix, the condition is not anymore a precursor but called invasive cancer.
The choice of treatment for cervical cancer depends on the exact place and size of the tumour, the stage (extent) of the disease, the woman's age and general health, and other factors.
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Staging
Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. Blood and urine tests usually are done. The doctor will do a thorough gynaecological assessment. Other examinations, the doctor may do include procedures called cystoscopy and proctosigmoidoscopy. In cystoscopy, the doctor looks inside the bladder with a thin, endoscopic instrument. Proctosigmoidoscopy is a procedure in which a similar instrument with a light source is used to check the rectum and the lower part of the large intestine.
Because cervical cancer may spread to the bladder, rectum, lymph nodes, or lungs, the doctor also may order x-rays or other tests to check these areas. The woman may first have a sonar examination of her kidneys to see whether the kidney pipes (ureters) are obstructed by the tumour. If this is abnormal it may be followed by a series of x-rays of the kidneys and bladder, called an intravenous pyelogram. To look for lymph nodes that may be enlarged because they contain cancer cells, the doctor may order a CT or CAT scan, which is a series of x-rays put together by a computer to make detailed pictures of areas inside the body. Another rather expensive procedure that may be used to check organs inside the body is magnetic resonance imaging (MRI).
Preparing for treatment
Most women with cervical cancer want to learn all they can about their disease and treatment choices so they can take an active part in decisions about their medical care. The specialist oncologist and others on the medical team can help inform women.
When a woman is diagnosed with cancer, shock and stress are natural reactions. These feelings may make it difficult for patients to think of everything they want to ask the medical team. Often it helps to make a list of questions. To help remember what was said, patients may take notes or ask whether they may use a tape recorder. Some people also want to have a family member or friend with them when they talk to the medical team - to take part in the discussion, to take notes, or just to listen.
Patients should not feel they need to ask all their questions or remember all the answers at one time. They will have more opportunities to ask the doctor to explain things and to get more information.
Here are some questions a woman with cervical cancer may want to ask the doctor before her treatment begins:
What is the stage (extent) of my disease?
What are my treatment choices? Which do you recommend for me? Why?
What are the chances that the treatment will be successful?
What are the risks and possible side-effects of each treatment?
How long will the treatment last?
Will it affect my normal activities?
What is the treatment likely to cost?
What is likely to happen without treatment?
How often will I need to have check-ups?
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