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Staging means finding out how far ovarian cancer has spread in your body. Physicians group ovarian cancer into stages I (1) through IV (4), with stage I being the least advanced and stage IV being the most advanced.
When your Fred Hutch Cancer Center team designs your treatment plan, they will take into account the stage of your cancer along with many other factors. Knowing the stage is an important part of choosing which treatments are right for you.
Ovarian Cancer Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.
Referrals are required for new patients. Please request your primary care provider or specialist fax all relevant medical information to the fax number listed below.
Phone: 206.598.8300
Fax: 206.598.3590
Stage I (1)
Cancer is in one or both ovaries or fallopian tubes.
- Stage IA: Cancer is in only one ovary or fallopian tube.
- Stage IB: Cancer is in both ovaries or fallopian tubes.
- Stage IC: Cancer is in one or both ovaries or fallopian tubes and one of these is true:
- The tumor broke open during surgery.
- The outer covering of the ovary broke open before surgery, or cancer is on the surface of the ovary or fallopian tube.
- Cancer is in the fluid in the peritoneal cavity (space that holds most of the abdominal organs), or cancer cells are found in salt water that your physician used to wash this cavity.
Stage II (2)
Cancer is in one or both ovaries or fallopian tubes and has spread to another part of the pelvis, or primary peritoneal cancer is in the pelvis.
- Stage IIA: Cancer has spread from where it started to the uterus, the fallopian tubes or the ovaries. It may have spread to one or more of these places.
- Stage IIB: Cancer has spread from an ovary or fallopian tube to organs in the peritoneal cavity.
Stage III (3)
The cancer is in one or both ovaries or fallopian tubes or is primary peritoneal cancer. It has spread outside the pelvis to other parts of the abdomen, nearby lymph nodes or both.
- Stage IIIA: Cancer has spread only to lymph nodes behind the lining of the peritoneal cavity (peritoneum), or cancer has spread to the surface of the peritoneum outside the pelvis and is so small it can only be seen with a microscope.
- Stage IIIB: Cancer has spread to the peritoneum outside the pelvis, and the tumor is 2 centimeters (cm) across or smaller.
- Stage IIIC: Cancer has spread to the peritoneum outside the pelvis, and the tumor is more than 2 cm across.
Stage IV (4)
Cancer has spread to parts of the body outside the abdomen.
- Stage IVA: Cancer is in extra fluid around the lungs with no other areas of cancer spread outside the abdomen.
- Stage IVB: Cancer has spread to the inside of the spleen or liver, to lymph nodes (other than the retroperitoneal lymph nodes), and/or to other organs or tissues outside the peritoneal cavity.
How to Know Your Ovarian Cancer Stage
If your provider suspects you have ovarian cancer, you will have imaging scans and other tests, like biopsies, to make the diagnosis and to tell if the cancer has spread. In a biopsy, a pathologist checks samples of tissue under a microscope to see if they contain cancer cells. Imaging might include an X-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or positron emission tomography (PET) scan.
For ovarian cancer, staging is typically done at the time of surgery. This means you and your care team will probably need to wait until after surgery to make some of your treatment decisions.
Ovarian Cancer Survival Rates
In cancer care, “survival rate” usually means the percentage of people expected to survive their cancer for at least five years from the time it was diagnosed. Data experts estimate this rate based on information about large groups of people with the same type of cancer. The rate doesn’t include the risk of dying during that five years for some other reason.
Even within a subset of people, like those with localized disease, there will be differences. Patients may have different treatments and respond to treatments in different ways.
This means it’s impossible to predict the likely lifespan of any one person based on survival rates. If you would like to know more about the outlook for your disease, talk with your Fred Hutch care team. They can tell you more based on your unique situation.
In general, people who have the same stage of ovarian cancer often have the same or similar treatments. At stage I (1), your options may depend in part on if you want to become pregnant in the future. Common treatments by stage may include:
- Stage I (1): Surgery to remove the tumor and usually the uterus (hysterectomy) and both ovaries and both fallopian tubes (bilateral salpingo-oophorectomy). Some people who want to become pregnant may have surgery to remove only the affected ovary and fallopian tube at first. Some people have chemotherapy after surgery.
- Stage II (2): Hysterectomy, bilateral salpingo-oophorectomy and surgery to remove as much of the tumor as possible. Some people have chemotherapy given through a vein (intravenous) or put into the abdomen through a tube (intraperitoneal).
- Stage III (3): Hysterectomy, bilateral salpingo-oophorectomy and surgery to remove as much of the tumor as possible. If the cancer has spread to other abdominal or pelvic organs, like the intestines or bladder, these may be removed too. After surgery, people have intravenous chemotherapy, sometimes along with targeted therapy. Some have intraperitoneal chemotherapy. For people who aren’t well enough to have surgery first, chemotherapy may help control the disease and make surgery possible.
- Stage IV (4): Treatment is similar to stage III.
Learn more about ovarian cancer treatment.
Researchers at Fred Hutch and beyond are always looking for better ways to treat advanced or metastatic ovarian cancer. Clinical trials are going on to test new drugs or new combinations of drugs. Two important areas of research are targeted therapies and immunotherapies. Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. Immunotherapies use the power of your immune system to fight your cancer.
New medicines aren’t the only line of inquiry. Other advanced approaches are helping people with late-stage disease get better results. One such approach is CRS-HIPEC. For this treatment, surgeons remove tumors they can see. Then they bathe the inside of the abdomen in warm liquid chemotherapy. Fred Hutch offers this treatment, which isn’t available at all cancer centers.
Learn more about ovarian cancer treatment.