Metastatic cervical cancer is cervical cancer that has spread to distant regions of the body, such as the lymph nodes, lungs, or liver.

Cervical cancer affects the lower part of the uterus — the area that connects the vaginal canal to the upper uterus. Metastatic cancer refers to the spread of cancerous cells from their original location. Metastatic cervical cancer makes up approximately 15% of all cervical cancer cases in the United States.

This article explores metastatic cervical cancer and the treatment options available.

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Metastatic cervical cancer originates in the cervix and spreads beyond it to distant tissues or organs. Doctors also call it stage 4 cervical cancer.

Cervical cancer begins when cells in the cervix change. These cells can develop into cancer and spread beyond the cervix to other sites in the body.

Cervical cancer can metastasize if treatment for early stage cervical cancer is ineffective or delayed. More than half of people with invasive cervical cancer have metastases elsewhere in the body at the time of diagnosis. This is because early cervical cancer often causes no obvious symptoms.

According to the American Cancer Society (ACS), 9 in 10 cervical cancers are squamous cell carcinomas, which develop in cells in the exocervix. The exocervix is the outer part of the cervix that opens into the vagina.

The remaining cervical cancers are mostly adenocarcinomas, which develop from glandular cells in the endocervix. The endocervix is the inner part of the cervix connecting the vagina and uterus. Sometimes, cervical cancers have features of both types, which doctors call adenosquamous carcinomas.

Learn about invasive cancer and how it differs from metastatic cancer.

Cervical cancer can metastasize to organs or tissues beyond the cervix. The majority of cervical cancer metastases occur in the lymph nodes.

In a 2020 study looking at data from 2010–2016, researchers found that nearly 70% of metastatic cervical cancer cases had only one location of metastases in the body. Of these cases, 37.9% of metastases occurred in the lungs.

Other locations include:

  • bones
  • liver
  • brain

Learn about cancer in the lymph nodes.

The ACS estimates that doctors will diagnose 13,960 new cases of invasive cervical cancer in 2023.

Doctors may suspect cervical cancer if:

  • a person has an abnormal result from an HPV or Pap screening test
  • a person experiences symptoms such as unexpected vaginal bleeding and pain during sex

In these situations, doctors may recommend further tests, including:

  • Medical history and physical examination: This helps a doctor understand a person’s risk factors and general health.
  • Colposcopy: A doctor inserts a speculum into the vagina to keep it open. They examine the surface of the cervix with a colposcope, an instrument with a magnifying lens.
  • Cervical biopsy: If a doctor finds an abnormal area on the cervix, they may order a biopsy. A biopsy involves removing a small piece of tissue for examination in a laboratory.

If a biopsy indicates cancer, doctors may recommend the following tests to determine whether the cancer has spread:

  • Cystoscopy: A gynecologic oncologist checks the bladder and urethra for signs of cancer growth using a light and small camera.
  • Proctoscopy: A doctor inspects the rectum using a lighted tube to check for signs of cancer in the rectum. They may also check a person’s pelvic region for signs of cancer growth beyond the cervix.
  • Imaging scans: Scans such as MRI, CT, and PET scans can show detailed images of metastases locations.

Various factors determine treatment options for metastatic cervical cancer. These include:

  • cancer stage
  • the location and extent of the cancer
  • cancer type
  • a person’s age and overall health
  • whether the person wants to retain fertility

Common treatments for cervical cancer include:

If the site of metastasis is within a person’s pelvic region, surgery to remove the affected tissues or organs may be possible. For example, a hysterectomy to remove the reproductive organs may eliminate the cancer.

The most common treatment for metastatic cervical cancer is a combination of chemotherapy and radiation therapy. These therapies help shrink tumors and prevent cancer cell growth.

If there are multiple sites of metastasis, treatment is typically palliative. The primary goal of this treatment is to extend life, reduce pain, and optimize a person’s quality of life.

Metastatic cervical cancer is difficult to treat. The outlook varies depending on the type of cancer, the extent and location of spread, and a person’s general health.

Between 2013 and 2019, the average 5-year relative survival rate for people with distant metastatic cervical cancer at diagnosis was 15%. This means people with the condition were 15% as likely to be alive 5 years after diagnosis compared with people without it.

It is important to remember that this figure is an estimate based on the results of previous studies or treatments. A person can consult a healthcare professional about how cervical cancer will affect them.

Read more about cervical cancer outlook.

Metastatic cervical cancer has spread beyond the cervix to other tissues or organs. It is an advanced stage of the disease.

Cervical cancer commonly spreads to the lymph nodes but can also spread to other areas, such as the lungs, bones, and liver.

Treatment depends on many factors and may involve surgery, chemotherapy, radiation therapy, or immunotherapy.