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Ovacome is a national charity providing support to anyone affected by ovarian cancer. We give information about symptoms, diagnosis, treatments, research and screening. Ovacome also runs a telephone support line and works to raise awareness and give a voice to all those affected by ovarian cancer.

This information is for those who have been diagnosed with stage 3 ovarian cancer and want to know more about their cancer and how it is treated.

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Cancer staging

The ovarian cancer stage means how far your cancer has spread at the time it is discovered. 

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. 

Sometimes the stage of the cancer is only apparent when it is seen during surgery.  A range of samples from around the abdomen, as well as samples of fluid used to wash out the abdomen during surgery, are sent away for examination under a microscope.  It is usually possible to identify the stage of your cancer from these samples.

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

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What is stage 3 ovarian cancer?

Stage 3 ovarian cancer is when the cancer is in one or both of the ovaries or fallopian tubes and has extended beyond the pelvis into the abdomen and sometimes into the lymph nodes. It is the most common stage at which ovarian cancer is diagnosed.

Stage 3 ovarian cancer is divided into three further categories: 

• 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.

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Grading stage 3 cancers

Your cancer will also be graded to show how active it is and how quickly or slowly it may grow.

Grade 1 (sometimes called well differentiated cancer) means that when it is seen under a microscope the cells look similar to normal cells which means they are likely to grow slowly.

Grade 2 (moderately differentiated) means the cells look more abnormal and are expected to be slightly faster growing.

Grade 3 (poorly differentiated or undifferentiated) means the cells look very different from normal cells and are expected to grow more quickly.

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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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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.

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). 

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. 

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Support for you

Ovacome is the UK 's national ovarian cancer support charity. We've been providing emotional support and personalised, expert information since 1996. Contact our support line by phone, email or text if you have questions about a diagnosis, or if you just want to talk things through.

We support anyone affected by ovarian cancer, including family members, carers, those with an inherited risk, and health professionals working in the field.

We run support group and events, both in person and online, providing an opportunity to connect with others. Find out more about our groups and events here.

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If you would like more information on the sources and references for this page, or if you would like to discuss anything about ovarian cancer, please phone our support line on 0800 008 7054 Monday to Friday between 10am and 5pm.

Booklet text reviewed by Professor Sean Kehoe MD DCH FRCOG. Professor of Gynaecological cancer and lead clinician, Oxford Gynaecological Centre, Churchill Hospital, Oxford; Senior Research Fellow, St Peters College, Oxford; Member of the International Federation of Obstetrics and Gynaecology (FIGO) Gynaecological cancer committee.

V.2.1. Last updated February 2022, due for review February 2024

Disclaimer: Ovacome booklets provide information and support.  We make every effort to ensure the accuracy and reliability of the information at the time of printing.  The information we give is not a substitute for professional medical care.  If you suspect you have cancer you should consult your doctor as quickly as possible.  Ovacome cannot accept liability for any inaccuracy in linked sources. Rights reserved.

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