Stages of ovarian cancer
This page describes how ovarian cancer is classified into four stages when diagnosed and what treatment can be offered for each stage. There is a glossary to explain words you may not be familiar with.
Ovarian cancer stages refer to how far the cancer has spread at the time it is diagnosed. Your team may determine this based on scans or after surgery when your surgeon has seen the cancer. Laboratory reports will confirm the stage and what type of ovarian cancer you have. The system of staging also applies to fallopian tube and primary peritoneal cancers.
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Stage 1 ovarian cancer
This is the earliest stage and means that the cancer affects only one or both of the ovaries, or one or both fallopian tubes. At this stage the cancer may cause few symptoms and most people are not aware that anything is wrong.
About 20 per cent (one in five) of people have their cancer found at this early stage.
Even if a cancer appears to affect only the ovary, it is still possible that it has spread. To be certain that a cancer is at stage 1 samples from other areas of the body are taken during surgery and examined under the microscope.
If cancer is confirmed as stage 1, the outlook is good. This is particularly the case if the cancer is confined to one ovary, stage 1a, or both ovaries, stage 1b, when surgery alone may be enough to treat it.
Stage 1c is when the cancer is limited to one or both ovaries, or fallopian tubes. But at this stage cancer cells may have leaked into the abdomen during initial investigative surgery (stage 1c1); the ovary may have ruptured before surgery or there may be a tumour on the ovary or fallopian tube surface (stage 1c 2); or there may be cancer cells present in abdominal fluids (stage 1c 3). Stage 1c ovarian cancer usually requires chemotherapy.
You can find more information about stage 1 ovarian cancer here.
Stage 2 ovarian cancer
This is when the cancer has spread outside the ovary into the pelvis or has gone into the uterus (womb). Primary peritoneal cancer is classified as stage 2.
Ovarian cancer at stage 2 is only found in a small number of people with the disease. This is because the lining of the pelvis and abdomen are not separated, so the cancer usually spreads to the abdomen at the same time as the pelvis.
Ovarian cancer is classified as stage 2a when it has spread to the uterus (womb) or fallopian tubes. Stage 2b is when the tumour has spread into other pelvic tissues.
If you have stage 2 ovarian cancer you are likely to be offered chemotherapy as well as surgery.
You can find more information about stage 2 ovarian cancer here.
Stage 3 ovarian cancer
This is the most common stage at which ovarian cancer is diagnosed. At this stage the cancer may have spread beyond the pelvis to the lymph nodes in the peritoneum (the lining of the abdominal cavity).
Stage 3a1 is when the cancer has spread only to the peritoneal lymph nodes, these are nodes in the abdominal area. Stage 3a1(i) means the disease in the lymph nodes measures up to 10 millimetres in diameter, 3a1(ii) means that cancer in the lymph nodes measures more than 10mm. Stage 3a2 is when microscopic disease has spread beyond the pelvis with or without affecting the peritoneal nodes.
Stage 3b means visible disease has spread beyond the pelvis and measures less than two centimetres with or without affecting the peritoneal nodes.
Stage 3c is visible disease beyond the pelvis measuring more than 2cms, with or without involving the peritoneal nodes, including the surface of the liver and the spleen but not within these organs.
At stage 3 the tumour on the lining of the abdomen (peritoneum) may release fluid which collects inside the abdomen. This collection of fluid is called ascites.
You can find more information about stage 3 ovarian cancer here.
Stage 4 ovarian cancer
Stage 4 ovarian cancer has spread beyond the abdomen to more distant organs.
Stage 4a is when the cancer causes a build-up of fluid between the lining of the lungs and the chest wall, called a pleural effusion. This can result in breathlessness. Tests show this fluid contains cancer cells.
Stage 4b is when the cancer has spread within other more distant organs including lymph nodes outside the abdominal cavity.
If you have stage 3 or stage 4 ovarian cancer you may be offered surgery and chemotherapy. You may be offered some chemotherapy before surgery and the rest of the course afterwards. In some cases chemotherapy alone may be the best treatment.
You can find more information about stage 4 ovarian cancer here.
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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.
Ovacome has over 50 information booklets on a variety of topics about ovarian cancer.
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