Just a question if anyone has insight on how the staging works. I sometimes hear 1b3 is advanced, sometimes stage 2 starts “advanced” —I’m confused because 1b3 is still confined to cervix whereas “advanced” suggests the cancer has grown beyond the cervix. All I can really come up with is that even though 1b3 is confined to the cervix, the treatment is the same as advanced stages because the tumor is larger & therefore more likely to spread? Thank you if anyone can elaborate on this!
Hi lovewinz
I dont know whether this may help but I am a stage 1b2 (1b1 before histology results) and i was classed as locally advanced, rather than advanced per se, the tumour being up to 4cm and still confined to the cervix.
Treatment for me has been a radical hysterectomy with some adjuvant chemotherapy starting in a couple of weeks (the chemo is due to a rarer type of cell change in my tumour mixed with adenocarcinoma, i have been told there is no evidence of disease left due to clear margins and negative lymph nodes but this rare type has a higher risk of recurrance so they are trying to stop that, not everyone seems to need this after a hysterectomy)
I think there is a fine line in terms of treatment between later stage 1 and early stage 2 because of the risk of spread as you say and surgery as the primary treatment seems to be preferred at that level based on my own experience and stories of other ladies. Thats not to say its a definite I think it depends on peoples own diagnosis and situation.
My understanding (and i may be wrong apologies) is that the higher up into stage 2 you go and beyond, surgery is not always possible or its not the first line of treatment and chemoradiotherapy/chemo and/or brachy is used.
Hope this helps a bit but if you have any questions re my experience please let me know ill be happy to tell you how its gone for me 
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Thank you so much for that clear explanation LBN2022.
I am heading into my 4th week of chemorads & I wasn’t given the option of surgery…I was such a mess prior to the start of treatment with such awful symptoms I didn’t ask enough questions at the time, I was just desperate to feel better. Having done some research on it, I think it’s probably for the best just to get that radiation on not just the tumor but the pelvic lymph area immediately (PET scan showed no lymph enlargement but what about micro metastasis right?). I wish I had asked more questions about treatment options but really my only question was “can we begin YESTERDAY?” I spent a lot of time prior to diagnosis getting negative scans and biopsies & my tumor is endocervical so perhaps that has something to do with the aggressive approach to treatment. I’ll have to ask more pointed questions when I see him in about a week but obviously my treatment is set in stone regardless at this point.
My radiation oncologist described me as in “a grey area” and “cuspy” so I’m assuming they are not sure if I’ll respond to treatment in the manner of a stage 1…he is going to call me later this week to discuss my brachy plan based on my current scans—either I get the brachy in patient or out patient. Another thing I seemed to turn up by Dr Google was that 1b2 has a significantly better prognosis generally than 1b3. It seems that 1b3 is maybe teetering off the cliff a bit in what the Drs can predict as far as prognosis. I assume it’s just because of how adenocarcinoma tends to micro metastasis & they want to get each an every cell line before they are able to “colonize” outside of the cervix,
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Hi lovewinz
I hope youre doing ok on treatment. I completely understand about not asking questions I was exactly the same and every letter I would get had something new in the diagnosis section that I hadnt heard of before. Yes mine is/was in the endocervix too and was mixed with neuroendrocrine which is the blighter that has the higher recurrence rate. I understand re the microscopic cells, my chemo is being used to almost ‘mop up’ any that may have drifted off from the main tumour. Theyve said to me that they are seeing more and more diagnoses of endocervical as theyve gotten better at identifying it but yes i was told due to the location of it and chance of spread they are hitting it quite hard in terms of treatment. My nurse said my approach is belts and braces and giving it everything now to try and avoid microscopic spread and recurrence.
I wonder whether you can still ask for surgery after your chemo/rads ie a hysterectomy im not too familiar with what they can do/do afterwards where primary treatment is chemo but possibly worth am ask?
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Wow it’s good to hear (but also the last thing I’d like to hear) that I’m not the only one in this mess. Treatment is going well, I’m grateful that I seem to be tolerating it well, all my symptoms basically disappeared overnight in the first week. I’m so glad they are giving you an extra boost with the chemo, is it Cisplatin? And how well are you tolerating it if you have begun? The strange thing is that my Dr told me they will consider surgery if I don’t respond well to radiation. I suppose there is complexity in my case that hasn’t been fully communicated to me because it does seem a little backward/unusual. All my best wishes for your treatment—we got this 
Hi
According to Macmillan:
Early-stage cervical cancer – this usually includes stages 1A to 1B1.
Locally advanced cervical cancer – this usually includes stages 1B2 to 4A.
Advanced-stage or metastatic cervical cancer– this usually means stage 4B.
https://www.macmillan.org.uk/cancer-information-and-support/cervical-cancer/stages
Doesn’t really explain why the various stages of cc are described in those ways. Seems a bit arbitrary to me.
x
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Thanks lovewinz, i start chemo in 2 weeks ill be on carboplatin and etoposide mainly i believe for the neuroendrocrine. We have definitely got this! Glad youre tolerating the treatment well and fingers crossed it does what it needs to do. If you do need any surgery and have any questions about my experience with a radical hysterectomy let me know, like youve said before re starting treatment i just said yes absolutely to the surgery but i appreciate everyone is im different positions and stages in life.
I have read on other cancer diagnoses that they try to shrink the tumour before surgery so perhaps this could be why they started with chemo/rads but definitely ask the questions at your next appointment
Sending hugs xx
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