Spread of cervical cancer

Local spread:

• vagina, bladder, bowel, transverse cervical ligaments, arteries, uterus

Lymphatics:

• outwards in the pelvic fascia to internal iliac nodes, then to common iliac nodes, and para-aortic nodes

Haematogenous - relatively uncommon; the patient often dies from the effects of local invasion before metastases to distant sites are clinically apparent:

• principally, to the lung, bone, and brain