Once a doctor diagnoses ovarian cancer, they need to determine if it has spread and, if it has, how far. This is known as staging. A cancer’s stage describes the amount of cancer present in the body, how severe the cancer is, and the best treatment methods.
Doctors take tissue samples from a person’s pelvis and abdomen to stage ovarian cancer.
Ovarian cancer stages range from 1–4. The lower the stage, the less the cancer has spread. Higher stages mean that the cancer has spread farther.
After diagnosing and staging a person’s ovarian cancer, the doctor will discuss the available treatment options.
This article examines the treatment options for each stage of ovarian cancer. It also looks at the support available for people with ovarian cancer.
According to the
Surgery is the
The type of surgery a person undergoes depends on their general health and how far the cancer has spread. If the cancer is in the earliest stage, it may be possible for doctors to treat it without removing both ovaries and the uterus.
There are two main goals of surgery: staging and debulking. The sections below look at these in more detail.
Doctors stage cancer to see how far it has spread. Staging
The surgeon may also remove the omentum, which is a fatty layer of tissue that covers the abdomen, and some lymph nodes in the pelvis and abdomen. Additionally, they will remove any fluid present in the pelvis or abdominal cavity for testing.
The surgeon will also remove as much of the tumor as possible, which is known as debulking. Surgery aims to leave behind no visible tumors larger than
Radiation therapy involves healthcare professionals using high energy X-rays or particles to kill cancer cells. Doctors
Chemotherapy is usually a systemic treatment, wherein drugs enter directly into the bloodstream and reach almost all bodily areas. Doctors often give chemotherapy intravenously, orally, or through a catheter into the abdominal cavity.
Chemotherapy for ovarian cancer typically involves two types of drugs. Doctors may use a combination of platinum compounds, such as cisplatin or carboplatin, and taxanes, such as paclitaxel or docetaxel. They usually give these intravenously every 3–4 weeks for three to six cycles, depending on the stage of the ovarian cancer.
Hormone therapy involves a doctor using hormones or hormone-blocking drugs. Doctors
Targeted therapy uses drugs to identify and attack cancer cells without significantly damaging normal healthy cells. Each type of targeted therapy works differently, but they all affect how cancer cells:
- interact with other cells
Stage 1 cancer remains in the ovaries and has not spread to the abdomen, pelvis, lymph nodes, or anywhere else in the body. It is an early stage and has the best outlook.
The first treatment for stage 1 ovarian cancer is surgery to remove the tumor. Usually, a surgeon will remove the uterus, both ovaries, and the fallopian tubes. The treatment after surgery depends on the substage of the cancer.
Ovarian cancer substages further divide the stages according to the size of the tumor, the spread to nearby lymph nodes, and the spread of the cancer to distant sites.
- Stage 1A: This means that the cancer is in one ovary.
- Stage 1B: This means that the cancer is in both ovaries but has not spread beyond the ovaries.
- Stage 1C: This means that one, some, or all of the following are present:
- The tissue surrounding the tumor tears during surgery, and the cancer spreads to the pelvis and abdomen.
- There are cancer cells in the fluid of the pelvis and abdomen.
- The tissue around the tumor ruptures before surgery.
- There is cancer on the surface of one ovary or both ovaries.
After surgery, a person may not require further treatment, depending on the severity of the tumor. If the tumor is low grade, an individual may keep one ovary and the fallopian tube on that side if they would like to have children.
If someone has stage 1B or 1C ovarian cancer, they may need chemotherapy and additional surgery in the future.
In stage 2, the cancer
- Stage 2A: This means that the cancer spreads to the fallopian tubes.
- Stage 2B: This means that the cancer spreads to other nearby pelvic organs.
A person may need surgery for staging and debulking, which usually includes a complete hysterectomy, a BSO, and chemotherapy.
At stage 3, the cancer spreads to other parts of the abdomen, lymph nodes, or both but not to more distant sites in the body.
- Stage 3A: This means that the cancer spreads to lymph nodes nearby or beyond the pelvis.
- Stage 3B: This means that the cancer spreads to the peritoneum, which is a membrane that lines the abdominal cavity. It also may spread to the lymph nodes behind the peritoneum.
- Stage 3C: This means that the cancer spreads to the peritoneum and is larger than half an inch. The cancer may also spread to the liver, spleen, or lymph nodes in the abdomen.
Doctors often treat stage 3 ovarian cancer in a similar way to stage 2. However, people may require more cycles of chemotherapy and more careful monitoring for additional treatment.
At stage 4, the cancer spreads outside of the abdomen. Doctors will be able to detect cancer outside of the area of the primary cancer. This is known as metastatic cancer.
- Stage 4A: This means that doctors can detect cancer cells in the fluid surrounding the lungs.
- Stage 4B: This means that the cancer spreads beyond the abdomen and may be present in the lymph nodes of the groin.
A doctor will determine the treatment for stage 4 ovarian cancer depending on the person’s needs. Treatment typically begins with chemotherapy, to shrink the cancer, and then surgery. Alternatively, the doctor may opt for surgery as a first means of treatment, with chemotherapy coming afterward.
Sometimes, the doctor may recommend combining treatments from different categories. For example, they may suggest combining targeted therapy with immunotherapy for people in whom other treatments have not worked.
People who are looking for ovarian cancer support can call the
Some other organizations that provide support include:
- The National Ovarian Cancer Coalition
- The National LGBT Cancer Project
- The Ovarian Cancer Research Alliance
Several cancer organizations provide support specifically for People of Color. These include:
The most common treatment that doctors use for ovarian cancer is surgery. Surgery often involves a hysterectomy with a BSO. Together, these procedures remove the uterus, both ovaries, and the fallopian tubes.
Depending on the severity of the cancer a person has, a doctor may use additional treatment options, including, most commonly, chemotherapy. They may also treat ovarian cancer using radiation therapy, hormone therapy, targeted therapy, or immunotherapy.
Doctors categorize stages 1–4 of ovarian cancer according to the spread of the cancer. People who have stage 1 cancer and low grade tumors may not require further treatment after surgery. However, having higher grade tumors often means that a person will need chemotherapy following surgery.