As in most types of abnormal growths of tissues, the severity of cervical cancer is graded in various stages. In order to perform the staging of this disease, information needs to be gathered through certain procedures, listed here. These tests are essential to determine the subsequent course of action.
One or more of these procedures will need to be performed on the patient:
Pretreatment surgical staging: In some cases, an exploratory surgery may be required to perform a biopsy and determine whether the cancer has spread beyond the cervix. Depending on various factors, the cervical tumor may be fully removed at this time. Normally, this route of treatment is only pursued in the context of clinical trials.
Lymph Node Biopsy: This involves extracting an entire lymph node, or just a part of it. The extracted tissue is then analyzed by a pathologist, who uses a microscope to check for the presence of active cervical cancer cells in that part of the body.
Laparoscopic exam: In order to observe the inside of the abdomen, this procedure involves making tiny cuts - which are used as insertion points for a device called a laparoscope. This is an extremely thin and lighted tube-shaped apparatus that allows checking inside the abdomen optically. It also features attachments that allow collecting tissue samples for biopsy, or even performing certain types of surgery without the need to cut the patient open.
Cystoscopic exam: This procedure allows checking mechanically inside the urethra and bladder, looking for suspicious areas. This is done using a device called a cystoscope, which goes in through the urethra all the way to the bladder. This surgical device is shaped like a thin tube and features a lens along with light, to allow observing the inside of the bladder directly.
Computerized Tomography (CAT Scan/CT): This diagnostic tool involves getting detailed snapshots inside the body, layered as continuous slices along an axis. The pictures are captured with an x-ray and assembled in the computer to provide a detailed representation of the organs and tissues. In some cases, it may be required to inject a dye into the body to improve the contrast of the scan. CAT stands for "computerized axial tomography", and it's sometimes abbreviated as CT, "computerized (or computed) tomography".
Magnetic Resonance Imaging (MRI) or Nuclear Magnetic Resonance Imaging (NMRI): Through a combination of radio waves and magnets sorted through a computer, this exam provides highly detailed pictures of the inside of the body - which allows checking for the presence of cancer with higher precision than traditional tests.
Positron Emission Tomography Scan (PET scan): One of the most sophisticated diagnostic methods available, a PET scan allows checking for the presence of active cancer cells inside the body at a very detailed level. To achieve this, the technicians will first inject a small amount of radioactive glucose (a type of sugar) in the patient’s veins, before having the PET scanner spin around the affected area of the body. The result is a high resolution representation of the scanned areas, in which malignant cells will appear brighter since these types of cells take up glucose at a far higher rate than healthy cells.
Ultrasound test: By using high-energy sound waves, an ultrasound exam will carry out the analysis through echo localization; this technique allows telling apart healthy tissues and organs from suspected tumors (which are far more dense).
Thoracic X-Ray: Allows capturing snapshots of the inside of the chest; this is done by using an energy beam that goes through soft tissues and bounces back off bones and tumors, all of which will be highlighted on the resulting picture.
After performing one or more of these procedures, your oncologist will then compare the results with the data from the initial biopsy, as to determine the staging of the disease.