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Finding the Right Ovarian Cancer Treatment

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Stages of Ovarian Cancer and What They Mean

Medically Reviewed By William C. Lloyd III, MD, FACS
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Woman with doctor
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During ovarian cancer diagnosis, your doctor will stage the cancer to see how widespread it is. This usually involves surgery. The stage of your cancer depends on:

  • The size of the primary ovarian tumor

  • Whether cancer cells are in your lymph nodes

  • Whether the cancer has spread—or metastasized—to other organs

There are four stages for ovarian cancer: I, II, III and IV. Higher numbers indicate more severe disease. Lower stage cancers usually have a better outlook because they are more likely to respond to treatment. After staging the disease, your doctor will know what other treatments may be necessary.

Your cancer stage will also give your doctor information about your prognosis. It’s common to talk about the 5-year survival rate for cancer prognosis. This is the percentage of people treated five years ago who are still alive. Keep in mind that people may die of other causes within those five years. And treatments may improve compared to five years ago. Rely on your doctor for information most relevant to you.

Stage I

What does it mean?

Stage I ovarian cancer remains confined to one or both ovaries. It has not spread to the lymph nodes or other tissues.

How is it typically treated?

Surgery is the main treatment for stage I. It usually involves removing the ovaries, fallopian tubes, and uterus. Your doctor will likely recommend chemotherapy after surgery to kill any remaining cancer cells.

What is the long-term prognosis?

Treatment at this stage is likely to be successful. The 5-year survival rate is about 90% for most stage I ovarian cancers. This means 90% of women treated five years ago are still alive.

Stage II

What does it mean?

Stage II means the cancer has become invasive and spread outside the ovaries. Early stage II cancers have grown into the uterus. Later stage II cancers have spread to other areas or organs in the pelvis. This includes the bladder, the sigmoid colon, or the rectum. Cancer has not yet spread to other parts of the abdomen or distant sites.

How is it typically treated?

More extensive surgery is necessary at this stage because the cancer has begun to spread. You will receive chemotherapy after surgery.

What is the long-term prognosis?

Treatment is still likely to be successful for most women at this stage. The 5-year survival rate is about 70% at stage II.

Stage III

What does it mean?

Stage III cancer has spread beyond the pelvis to the abdominal wall or to lymph nodes at the back of the abdomen. It has not spread to distant lymph nodes or body sites.

How is it typically treated?

Treatment is similar to stage II. Doctors will remove as much of the cancer as possible in the process of debulking. This may involve removing parts of organs, such as the liver and intestines. Combination chemotherapy is necessary after surgery.

What is the long-term prognosis?

Because disease is more severe at this stage, treatment success is more difficult to achieve. The 5-year survival rate drops significantly to less than 50%.

Stage IV

What does it mean?

Stage IV cancer has spread beyond the abdomen to distant lymph nodes or body sites, most often the lungs and bones.

How is it typically treated?

Treatment can involve a combination of surgery, chemotherapy, and targeted therapies.

What is the long-term prognosis?

Current treatments cannot cure stage IV ovarian cancer. Instead, treatment is palliative, aiming to relieve symptoms and help prolong your life. The 5-year survival rate is 17%.

Discuss your cancer stage and treatment options with your doctor. Talk about the possibility of a clinical trial to see if you are a good candidate. Together, you can plan the best course of action for you.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Feb 18
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

  1. How Is Ovarian Cancer Diagnosed? American Cancer Society. http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-diagnosis

  2. How Is Ovarian Cancer Staged? American Cancer Society. http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-staging

  3. How Is Ovarian Cancer Treated? American Cancer Society. http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-treating-general-info

  4. Ovarian Cancer. American Society of Clinical Oncology. http://www.cancer.net/cancer-types/ovarian-cancer/overview

  5. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer. National Cancer Institute. http://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq

  6. Survival Rates for Ovarian Cancer by Stage. American Cancer Society. http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-survival-rates

  7. Treatment of Invasive Epithelial Ovarian Cancers by Stage. American Cancer Society. http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-treating-by-stage