Ovarian Cancer Stages and Treatment: What to Expect

If you’ve recently been diagnosed with ovarian cancer, it’s normal to feel uncertain about what happens next. One of the first things your doctor will discuss with you is the stage of your cancer. 

This article explains the main stages of ovarian cancer and the treatment options that are available at each stage. By understanding your diagnosis, you can take confident steps toward managing your health and recovery.

What is ovarian cancer?

You have two ovaries, one on each side of your uterus (womb). Ovarian cancer occurs when abnormal cells in one or both ovaries start to grow and divide uncontrollably, this is called ovarian cancer. These cells can invade nearby tissues or spread to other parts of the body.

Different stages of cancer

The ovarian cancer staging follows the staging system developed by FIGO (International Federation of Gynaecology and Obstetrics). The FIGO system divides ovarian cancer into four main stages based on how large the tumor is and how far it has spread from the ovaries, fallopian tubes, or the peritoneum.

The stage of ovarian cancer helps determine its extent and guides treatment options. Doctors use tests and imaging scans to estimate the stage at diagnosis. However, the exact stage may only be confirmed after surgery, when the surgeon and pathologist can directly see how far the cancer has spread.

This means that your cancer stage and treatment plan may change after surgery, as your doctor can see more clearly how far the cancer has spread.

Stage 1: Cancer is only in the ovaries

At this stage, cancer is found only in one or both of your ovaries or fallopian tubes (a pair of tubes that carry eggs from the ovaries to the womb). There are three groups in stage 1:

• Stage 1A:

  • Cancer is in one ovary or fallopian tube

• Stage 1B:

  • Cancer is in both ovaries or fallopian tubes

• Stage 1C:

  • Cancer is in one or both ovaries or fallopian tubes and:

    • Stage 1C1: Tumour’s outer capsule is broken during surgery

    • Stage 1C2: Cancer is found on the outer surface of ovary or fallopian tube

    • Stage 1C3: Cancer cells appear in fluid taken from your abdomen during surgery

Treatment of stage 1 ovarian cancer

The main treatment is surgery to remove the cancer and see how far it has spread. Your surgeon may remove your ovaries, fallopian tubes, and womb (including the cervix). For women  who want to preserve their fertility, your doctor may suggest fertility-sparing surgery to keep one healthy ovary and the womb.

Your doctor usually examines your abdomen and abdominal organs during the surgery. If there is no cancer outside the ovary, the cancer is confirmed as stage 1.

If you have high-grade serious cancer, in which the cancer cells look least like healthy cells and tend to grow rapidly, or if cancer is found on the surface of the ovary or in abdominal fluid, your doctor may suggest chemotherapy after surgery to lower the risk of recurrence of ovarian cancer.

Need guidance after your ovarian cancer diagnosis? Request an appointment with our gynaecological oncologists at Thomson Medical to understand your stage and receive a personalised treatment plan.

Stage 2: Cancer in the pelvic area

At this stage, cancer has spread outside your ovaries or fallopian tubes, and grown within the area between your pelvis. Stage 2 is divided into two groups:

• Stage 2A:

  • Cancer is in your ovaries and has spread to the fallopian tubes or womb.

• Stage 2B:

  • Cancer is found in other pelvic tissues, such as the bladder, bowel, but not beyond this area.

Treatment of stage 2 ovarian cancer

Treatment for stage 2 ovarian cancer usually involves a combination of surgical removal and chemotherapy. The goal is to remove as much of the cancer as possible and to prevent it from spreading further.

Your doctor will take out your womb, both ovaries, and fallopian tubes during surgery. They will also carefully examine your pelvic area and surrounding organs, including the bladder and bowel, to check if cancer has spread.

After surgery, most patients get chemotherapy for ovarian cancer to destroy any tiny cancer cells that are still there but can't be seen or taken out during the surgery.Sometimes, your doctor may suggest neoadjuvant chemotherapy (chemotherapy given before surgery) to shrink the tumor, making it easier to remove.

Stage 3: Cancer spreads to the abdomen or lymph nodes

When ovarian cancer reaches stage 3, it has spread to the lining of your abdominal cavity (peritoneum), or to lymph nodes in the back of your tummy. Stage 3 has three groups:

• Stage 3A1:

  • Cancer has spread to the lymph nodes in the back of your tummy.

  • If the lymph nodes are smaller than 1cm, you are at stage 3A1(i).

  • If the lymph nodes are larger than 1cm, you have stage 3A1(ii) ovarian cancer.

• Stage 3A2:

  • There are cancer cells in the peritoneum and may also be in your lymph nodes.

• Stage 3B:

  • Visible tumours up to 2 cm in the abdomen.

  • There might also be cancer in the lymph nodes.

• Stage 3C:

  • Tumours larger than 2cm.

  • Cancers may appear in your lymph nodes, or on the surface of your spleen or liver.

Treatment of stage 3 ovarian cancer

The main goal for stage 3 ovarian cancer is to remove as much cancer as possible, followed by chemotherapy. Your surgeon will usually take outyour womb, both ovaries, and fallopian tubes. Lymph nodes and other tissues in the pelvic region and abdomen that are suspected may also be removed.

If your cancer has spread widely, or if you are not well enough for surgery, your doctor may recommend chemotherapy on its own to shrink the cancer as much as possible and slow its growth.

Targeted therapy targets the genetic changes that turn healthy cells into cancer cells, using drugs designed to attack specific features of cancer cells while minimizing harm to healthy cells. Your oncologist will identify specific genetic changes in your cancer, then select treatments that target those specific abnormalities clevelandclinic. Targeted therapy may be an option for some women with stage 3 ovarian cancer.

Every woman’s cancer journey is unique. If you’ve been diagnosed with ovarian cancer, don’t face it alone. Our women’s cancer specialists at Thomson Medical are here to guide you through every stage of care.Request an appointment today.

Stage 4: Cancer spreads to distant organs

This is the most advanced stage, when cancer has spread to organs outside of your abdomen, like the lungs or inside the liver. There are two groups in stage 4:

• Stage 4a:

  • Cancer cells are found in fluid around your lungs.

• Stage 4b:

  • Cancer has spread to organs such as the liver, spleen, lungs, or distant lymph nodes outside of your tummy.

Treatment of stage 4 ovarian cancer

Stage 4 treatment focuses on controlling the cancer, easing symptoms, and improving your quality of life. Although a complete cure is often not possible, modern therapies can help slow the disease and relieve discomfort.

Treatment options may include:

• Surgery:

  • If possible, your doctors will remove as much of the tumour as they can to reduce symptoms and improve the effectiveness of other treatments.

• Chemotherapy:

  • Help slow cancer growth.

  • It can be given before or after surgery, or as the main treatment if you are unable to undergo surgery.

• Targeted therapy:

  • Help control tumour growth while limiting damage to normal cells.

• Radiotherapy:

  • Ease pain, control bleeding, or shrink tumours that are pressing on other organs.

• Supportive care:

  • Pain management, good nutrition, and emotional support are also important to maintain comfort and wellbeing.

FAQ

How fast can ovarian cancer spread?

What is the most effective treatment for ovarian cancer?

The type and stage of your cancer will determine what kind of treatment you get. Most patients receive a combination of surgery and chemotherapy. In advanced cases, your doctor may also include targeted therapy to improve response and survival.

Is ovarian cancer curable at stage 1?

Yes. Stage 1 ovarian cancer has a good chance of being cured if it is diagnosed early and treated right away. The average 5-year survival rate for women with stage 1 ovarian cancer is 93%.

Does stage 1 ovarian cancer need chemotherapy?

Chemotherapy is not required for every stage 1 case. Your doctor may recommend chemotherapy to lower the risk of recurrence if you have high-grade tumours or if the cancer is on the surface of the ovary or in abdominal fluid.

How long can I last with stage 4 ovarian cancer?

Stage 4 ovarian cancer is the most advanced stage of the disease. Although a complete cure is rare, many women live meaningful lives for years with modern treatments and supportive care. On average about 31 out of 100 women with stage 4 ovarian cancer will live for 5 years or more after being diagnosed. Your individual outlook depends on your overall health, response to treatment, and support from your care team.

Can targeted therapy help stage 4 ovarian cancer?

Yes, targeted therapy can be an effective treatment for stage 4 ovarian cancer, especially when specific genetic changes are found in the cancer cells. These drugs are often used along with chemotherapy or after other treatments to help slow the growth of the cancer and support longer survival. Your doctor will recommend targeted therapy if it is suitable for your type of ovarian cancer.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and advice based on your unique situation, please consult a specialist at Thomson Medical.Request an appointment with Thomson Medical today.

References:

1. What is ovarian cancer? (n.d.). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/what-is-ovarian-cancer

2. Types of ovarian cancer. (n.d.). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/types

3. Stages and grades of ovarian cancer. (n.d.). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/stages-grades