When cervical cancer spreads beyond the upper layers of cervical tissue (called the cervical endothelium) it begins to invade surrounding structures and organs. This transition from noninvasive cancer to locally invasive carcinoma in situ (CIS) is a grave milestone because it signals that the mass of cancer cells, collectively called a tumor or a lesion, has gained access to the rest of the body. Cancerous cells may spread through the vessels of the lymph system to lymph nodes in the pelvis or near the aorta, the largest artery in the body. These pelvic and para-aortic lymph nodes are called regional lymph nodes because they're the nodes closest to the site of the cancer. From there, the cancer can travel to distant sites such as bone and the liver, lungs, or brain. This process is called metastasis, from the Greek words meta, which in this case refers to a change or alteration, and stasis, meaning "standing still." Metastatic cancer carries a lower survival rate than noninvasive or locally invasive cancer.
Side Effects of Cancer Treatment
Aside from the progression of the disease itself, treatment may be marked by unwelcome, often life-changing complications:
- Infertility can be caused by removal of the ovaries or by radiation or chemotherapy, which can damage the ovaries and lead to ovarian failure.
- Removal of the ovaries during surgery, a procedure called oophorectomy, causes hormone production to stop, bringing about premature menopause in premenopausal women.
- Hormonal changes that accompany oophorectomy can also impair sexual functioning by causing problems such as vaginal dryness and a suppressed sex drive.
- A pregnant woman diagnosed with cervical cancer may risk harm to the fetus if treatment begins during pregnancy. However, therapy for early-stage cancer can often be delayed until after delivery without compromising a favorable treatment outcome. Some women may reluctantly elect to terminate a pregnancy rather than delay urgent treatment when cancer is more advanced.