An overview of the most common types of cervical cancer, including high- and low-grade SILs.
Cancer of the cervix also may be called cervical cancer. Like most cancers, it is named for the part of the body in which it begins. Cancers of the cervix also are named for the type of cell in which they begin. Most cervical cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that form the surface of the cervix.
When cancer spreads to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original (primary) cancer. For example, if cervical cancer spreads to the bones, the cancer cells in the bones are cervical cancer cells. The disease is called metastatic cervical cancer (it is not bone cancer).
Cells on the surface of the cervix sometimes appear abnormal but not cancerous. Scientists believe that some abnormal changes in cells on the cervix are the first step in a series of slow changes that can lead to cancer years later. That is, some abnormal changes are precancerous; they may become cancerous with time.
Over the years, doctors have used different terms to refer to abnormal changes in the cells on the surface of the cervix. One term now used is squamous intraepithelial lesion (SIL). (The word lesion refers to an area of abnormal tissue; intraepithelial means that the abnormal cells are present only in the surface layer of cells.) Changes in these cells can be divided into two categories:
Low-grade SIL refers to early changes in the size, shape, and number of cells that form the surface of the cervix. Some low-grade lesions go away on their own. However, with time, others may grow larger or become more abnormal, forming a high-grade lesion. Precancerous low-grade lesions also may be called mild dysplasia or cervical intraepithelial neoplasia 1 (CIN 1). Such early changes in the cervix most often occur in women between the ages of 25 and 35 but can appear in other age groups as well.
High-grade SIL means there are a large number of precancerous cells; they look very different from normal cells. Like low-grade SIL, these precancerous changes involve only cells on the surface of the cervix. The cells will not become cancerous and invade deeper layers of the cervix for many months, perhaps years. High-grade lesions also may be called moderate or severe dysplasia, CIN 2 or 3, or carcinoma in situ. They develop most often in women between the ages of 30 and 40 but can occur at other ages as well.
If abnormal cells spread deeper into the cervix or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. It occurs most often in women over the age of 40.
Preparing for Treatment
Many people with cancer want to learn all they can about the disease and their treatment choices so they can take an active part in decisions about their medical care. When a person is diagnosed with cancer, shock and stress are natural reactions. These feelings may make it difficult to think of everything to ask the doctor. Often, it helps to make a list of questions. To help remember what the doctor says, 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 doctor--to take part in the discussion, to take notes, or just to listen.
People do not need to ask all of their questions or remember all of the answers at one time. Questions may arise throughout the treatment process. Patients may ask doctors, nurses, or other members of the health care team to explain things further or to provide more information.
These are some questions a patient may want to ask the doctor before treatment begins:
- What is the diagnosis?
- What is the stage of the disease?
- What is the grade of the disease?
- What are the treatment choices? Which do you recommend? Why?
- What are the risks and possible side effects of each treatment?
- What are the chances that the treatment will be successful?
- What new treatments are being studied in clinical trials? Would a clinical trial be appropriate?
- How long will treatment last?
- Will treatment affect my normal activities? If so, for how long?
- What is the treatment likely to cost?
Regular follow-up exams--including a pelvic exam, a Pap test, and other laboratory tests--are very important for any woman who has been treated for precancerous changes or for cancer of the cervix. The doctor will do these tests and exams frequently for several years to check for any sign that the condition has returned.
Cancer treatment may cause side effects many years later. For this reason, patients should continue to have regular checkups and should report any health problems that appear.
© Copyright FamilyCare America, Inc.
This article is adapted from information in the What You Need to Know About™ Cancer series, published by the National Cancer Institute.