Metastatic ovarian cancer is when cancer cells have spread from the ovaries to more distant parts of the body. Treatment options include chemotherapy, surgery, and other targeted therapies.

An estimated 19,710 females in the United States will receive a diagnosis of ovarian cancer in 2023. Around 57% of people with ovarian cancer receive a diagnosis in the later stages, when the cancer has already reached more distant organs.

Ovarian cancer refers to cancer that starts in the ovaries. If it reaches the liver or another organ during metastasis, doctors still call it ovarian cancer.

The most common distant organ for ovarian cancer to metastasize to is the liver, followed by distant lymph nodes and the lungs, bones, and brain.

This article looks at how ovarian cancer can spread to other parts of the body, as well as the treatment options and outlook.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Not everyone has symptoms of ovarian cancer in the early stages. As a result, only 17% of people with ovarian cancer receive a diagnosis at an early stage, before the cancer has spread.

If symptoms occur, they may include:

  • urgency to urinate and having to pee more often
  • feeling full quickly after eating
  • pain or pressure that can resemble premenstrual syndrome

Over 70% of people with an early diagnosis of ovarian cancer say they have pain in the abdomen or pelvis. The pain can be either dull and constant or intermittent and intense.

As the initial tumor grows and cancer cells spread, the number of symptoms can increase. As cancer spreads to other organs, new symptoms can appear.

What are the early symptoms of ovarian cancer?

Pelvis and abdomen

As ovarian cancer grows, it usually spreads first into nearby organs and structures of the lower body, such as the pelvis and abdomen. Around 21% of people with ovarian cancer receive a diagnosis when the cancer has spread to nearby tissues.

At this stage, it may affect the:

  • fallopian tubes
  • uterus
  • cervix
  • abdomen
  • stomach
  • bladder
  • rectum
  • peritoneum, which is the lining and tissue of the abdominal cavity

A person may notice:

Often, a person does not notice any symptoms until the cancer has reached this stage.

Can ovarian cancer cause abdominal swelling?

Lymph nodes

Ovarian cancer cells can also spread to the lymph nodes and through the lymphatic system.

Symptoms of metastatic cancer in the lymph nodes may include:


Around 57% of diagnoses happen when cancer has already reached a distant organ.

The liver is the most common distant organ for metastatic ovarian cancer to spread to.

Symptoms of liver metastasis include:

  • appetite changes
  • weight changes
  • abdominal swelling
  • jaundice


Ovarian cancer that has metastasized to the lungs may lead to a buildup of fluid, called a pleural effusion.

A person may notice:


If ovarian cancer affects the bone, people may experience:

  • bone pain
  • swelling of the joints
  • mobility issues
  • bone fractures


Ovarian cancer that metastatizes to the brain may cause:

  • headaches
  • seizures
  • vision problems
  • changes in mood, memory, thinking, and concentration

What are the stages of ovarian cancer?

Doctors diagnose ovarian cancer according to the stage and the type of cells in the primary tumor.

The early signs of ovarian cancer can be hard to spot, and effective early screening methods are limited. For these reasons, most diagnoses happen at a later stage.

Tests to diagnose ovarian cancer include:

  • Pelvic exam: This is an in-person exam by a specialist, such as a gynecologic oncologist.
  • Imaging tools: Doctors may use a transvaginal ultrasound, CT scan, or MRI.
  • Blood tests: These include the CA-125 blood test, which measures biomarkers for cancer.
  • Gene tests: These tests can identify genetic features that may increase the risk of ovarian cancer.
  • Surgical biopsy: Doctors remove suspected cancerous tissue for examination by a pathologist.
  • Laparoscopy: Doctors look for changes inside the ovaries using a thin, lighted tube.

If a doctor suspect metastasis, they may also request:

  • a barium enema X-ray or colonoscopy to check the abdomen and pelvis
  • a chest X-ray to look for changes in the lungs
  • MRI scans to assess the brain and spinal cord

A biopsy will show what grade the cancer is. About 85–90% of ovarian cancers are a type of cancer known as epithelial ovarian carcinomas, which can be high or low grade. Lower-grade carcinomas grow more slowly than high grade ones.

Surgery is the standard treatment for ovarian cancer, but it may not be suitable for people with metastatic ovarian cancer, especially if the cancer has spread throughout the abdominal cavity.

A person can work with their doctor to decide on the best course of treatment based on the location, stage, and spread of the cancer.

Possible treatment options include:

  • Surgery: A physician can help identify whether surgery to remove affected tissues will be helpful.
  • Platinum-based chemotherapy: Cisplatin and carboplatin are the main options.
  • Antiangiogenic agents: These stop cancer from progressing by stopping the growth of blood vessels that feed the tumor. Examples include bevacizumab (Avastin) and paclitaxel.
  • PARP inhibitors: Targeted enzyme inhibitors, such as olaparib (Lynparza), may be used during a recurrence.
  • Alternative therapies: These include the diabetes drug metformin, which may have an anticancer effect. Researchers are also looking at how to use photodynamic therapy — a type of light therapy that can destroy cancer cells — to treat ovarian cancer.

Some combinations of treatments include:

  • a combination of the platinum-based drug carboplatin with the antiangiogenic agent paclitaxel
  • targeted therapies, such as bevacizumab alongside a PARP inhibitor
  • metformin together with carboplatin and/or paclitaxel

What are the treatment options by stage for ovarian cancer?

According to statistics from the National Cancer Institute, the relative 5-year survival rate for ovarian cancer is 47.9%.

For a person with an early stage diagnosis, this rate is 93.1%. This means the person has a 93.1% chance of living at least another 5 years compared with someone who does not have ovarian cancer.

However, if cancer has spread to nearby tissues, the 5-year survival rate is 74.2%, and if it reaches distant organs, it falls to 30.8%.

The outlook for metastatic ovarian cancer depends on:

  • how far cancer has spread
  • which organs it affects
  • the type and grade of cancer
  • individual factors, such as age

Research suggests that distant lymph node metastases have the highest overall survival rate, while lung metastases have the worst.

What are the survival rates for ovarian cancer?

Below are answers to some commonly asked questions about metastatic ovarian cancer.

Where does ovarian cancer spread first?

Metastatic ovarian cancer can spread through other reproductive organs and tissues before reaching the abdomen and nearby lymph nodes. After this, it may spread to more distant organs, such as the liver or lungs.

How fast does ovarian cancer spread?

Ovarian cancer can take years to develop, but once a person has a diagnosis, it can spread quickly.

Epithelial cancer, the most common type, can spread from the original site to distant organs in weeks or months. However, the rate of cancer growth will depend on the individual and the type or grade of cancer. High grade cancer, such as choriocarcinoma, can spread faster and more aggressively.

What are the stages and timing of ovarian cancer?

Ovarian cancer is the gynecologic cancer most likely to be fatal for females, particularly as 21% of diagnoses occur after cancer has spread to nearby lymph nodes and 57% occur after it has reached distant organs.

Treatment options are available, but treating late stage ovarian cancer can be challenging, especially if the cancer has spread to multiple organs.