This fact sheet describes how ovarian cancer is classified into four stages when diagnosed, and what treatment can be offered for each stage. There is a glossary to explain words you may not be familiar with. Further information on each of the four stages is in fact sheets 3a, 3b, 3c and 3d.
The stage of ovarian cancer means how far the cancer has spread at the time it is diagnosed. This may be based on scans or after surgery when your surgeon has seen the cancer. Laboratory reports will confirm the stage and what type of ovarian cancer you have. The system of staging also applies to fallopian tube and primary peritoneal cancers.
In stage 1, the cancer has not spread beyond the ovaries. Stage 1A means the cancer is only in one ovary. In stage 1B, the cancer is in both ovaries. Stage 1C means that one or both ovaries contain cancer cells and one of the following are also found: the outer capsule broke during surgery, the capsule burst before surgery, there are cancer cells on the outside of an ovary, or cancer cells are found in fluid washings from the abdomen.
In stage 2 ovarian cancer, the cancer is in one or both ovaries and has spread to elsewhere within the pelvis. Stage 2A means it has gone from the ovaries to the fallopian tubes, the uterus, or to both. Stage 2B indicates the cancer has migrated to nearby organs like the bladder, sigmoid colon, or rectum.
This is the most common stage at which ovarian cancer is diagnosed. At this stage the cancer may have spread beyond the pelvis to the lymph nodes in the peritoneum (the lining of the abdominal cavity).
Stage 3a1 is when the cancer has spread only to the peritoneal lymph nodes, these are nodes in the abdominal area. Stage 3a1(i) means the disease in the lymph nodes measures up to 10 millimeters in diameter, 3a1(ii) means that cancer in the lymph nodes measures more than 10mm. Stage 3a2 is when microscopic disease has spread beyond the pelvis with or without affecting the peritoneal nodes.
Stage 3b means visible disease has spread beyond the pelvis and measures less than two centimeters with or without affecting the peritoneal nodes. Stage 3c is visible disease beyond the pelvis measuring more than 2cms, with or without involving the peritoneal nodes, including the surface of the liver and the spleen but not within these organs.
At stage 3 the tumor on the lining of the abdomen (peritoneum) may release fluid which collects inside the abdomen. This collection of fluid is called ascites.
Stage 4 ovarian cancer has spread beyond the abdomen to more distant organs.
Stage 4a is when the cancer causes a build-up of fluid between the lining of the lungs and the chest wall, called a pleural effusion. This can result in breathlessness.
Stage 4b is when the cancer has spread within other more distant organs including lymph nodes outside the abdominal cavity.
If you have stage 3 or stage 4 ovarian cancer you may be offered surgery and chemotherapy. You may be offered some chemotherapy before surgery and the rest of the course afterwards. In some cases, chemotherapy alone may be the best treatment.