Stage 3 ovarian cancer

Cancer staging

The ovarian cancer stage means how far your cancer has spread at the time it is discovered. This may be assessed following your diagnostic tests but usually confirmed after surgery.

During your operation to remove the cancer the surgeon may take samples from the cancer and from fluid which are then examined under a microscope. This usually shows the stage of your cancer.

There may be evidence that you have stage 3 ovarian cancer during the initial investigations, or it may be indicated by your symptoms.  For instance, abdominal bloating may be caused by fluid in the abdomen which is a symptom of stage 3 disease. 

The system of staging also applies to fallopian tube and
primary peritoneal cancers.

This information is for anyone who has been diagnosed with stage 3 ovarian cancer and for anyone who wants to know more about this stage and its treatment.

What is stage 3 ovarian cancer?

• Stage 3a is diagnosed when an examination under a microscope finds cancer cells too small to be seen by eye in tissue samples taken from the lining of the abdomen. Stage 3a1 means that cancer cells have been found in lymph nodes behind the pelvis. Stage 3a1(i) is a secondary cancer of less than 10mm. Stage 3a1(ii) is a secondary cancer of more than 10mm. Stage 3a2 is when microscopic cancer cells have spread beyond the pelvis.
  
  
• Stage 3b means small tumours (2cm or less in size) have spread beyond the pelvis and are on the surface of the liver and spleen.
  
  
• Stage 3c is when larger tumours (greater than 2cm in size) are growing on the lining of the abdomen (peritoneum) or the surface of the liver or spleen.

Grading stage 3 ovarian cancer?

How is stage 3 ovarian cancer treated?

Stage 3 ovarian cancer is treated by a combination of surgery and chemotherapy.  This may be surgery followed by chemotherapy, or three cycles of chemotherapy (sometimes more) followed by surgery and then three further cycles of chemotherapy.

Your surgeon will remove your ovaries, fallopian tubes, womb and abdominal lining. They will also aim to remove any cancer growing on other organs.  Lymph nodes close to where the cancer has spread may also be removed. This surgery is called optimal cytoreduction or debulking surgery. You can find out more about surgery for ovarian cancer here.

Occasionally the cancer will have affected the bowel and it may be necessary to remove a section of the bowel and create a colostomy or ileostomy.  This is where an opening is created in your abdomen so that waste from your bowel can be collected in a small bag. This can be temporary; specialist staff will help you to manage this process.

You will need a period of some weeks to recover from your surgery.  After this you will begin a course of six chemotherapy treatments, given every three weeks.  It is likely that your consultant will recommend the use of two chemotherapy drugs called carboplatin and Taxol (paclitaxel). You can find out more about chemotherapy here.

Sometimes a consultant will also recommend treatment with a third drug called Avastin, a targeted therapy (monoclonal antibody) which interferes with the cancer’s blood supply. 

Ascites

At this stage the tumour on the lining of the abdomen may produce fluid which collects inside the abdomen. This collection of fluid is called ascites.  If this happens and becomes uncomfortable then your team may try and reduce it with chemotherapy or a simple procedure called ascitic drainage is carried out to drain off the fluid.

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