Like all cancers, ovarian cancer has a progression path if left untreated. This progression is categorized into four stages, each with their own set of identifying marks. Diagnosis at each stage has a different survival rate and its own treatments, which will be discussed in another article.
The following stages are apparent in ovarian cancer. All ovarian cancer types follow the same style of progression as they all originate within a woman’s reproductive system. For convenience, the stages have been laid out in chronological order.
Survival rates also accompany the stages, using the five-year relative survival rate. This rate counts women who have survived at least five years after their cancer battle.
Stage 1 ovarian cancer is the least deadly stage and has the highest survival rates of all the stages. It is characterized by the appearance of a tumor in one or both ovaries. There are, however, subcategories of this stage.
Stage 1A is when this cancer is confined to one ovary, with no appearance of cancer anywhere else in the body. There is no cancer on the outer surface of the ovary or in the fluid in the abdomen.
This stage is characterized by the presence of cancer in both ovaries, which are still intact. Much like stage 1A, this cancer is confined to the ovaries with no presence of cancer anywhere else in the body.
A progression from either stage 1a or 1b, this cancer is now not only in the ovary. Lab examinations will find cancer either on the outer surface of the ovary or in the fluid in a woman’s abdomen.
A woman who is diagnosed with stage 1 ovarian cancer can be reasonably assured she will survive this cancer battle, with a 92% 5-year relative survival rate. However, less than 25% of women are diagnosed with ovarian cancer at this stage.
Stage 2 of ovarian cancer is considered an advanced stage. This cancer is now not only in the ovaries, but has spread to other organs within the abdominal and pelvic area. At this stage, this cancer has spread, but still resides mainly within the pelvic area. There is a good chance of survival at this stage, as this cancer is still concentrated in one area.
At this stage, this cancer has spread from the original site of the tumor in the ovaries into the reproductive system — mainly the uterus or the fallopian tubes. In some cases, this cancer has spread to both. The growth grade of this cancer cells will determine the rate at which this cancer is progressing. At this stage, however, the cells have not reached any of the lymph nodes, which are located in the pelvis.
Stage 2b of ovarian cancer means that this cancer has branched out from ovaries and has invaded other pelvic organs that are not connected to the reproductive system. Some of the organs it may have spread to include the bladder, the rectum, and the colon.
In this case, the growth path of this cancer cells indicates a fast rate of growth that has this cancer moving quickly through the pelvic area.
Only four percent of all women are diagnosed at stage 2 of ovarian cancer. The current survival rate for women who have stage 2 ovarian cancer is 40%.
Stage 3 ovarian cancer is when this cancer has progressed to fully spread through the abdominal cavity. It has three substages, which track the path of this cancer.
This substage has two defining characteristics, and only one is needed to be classified under stage 3a. The first is that this cancer cells have now begun to invade lymph nodes called retroperitoneal lymph nodes. These are the closest in proximity to the ovaries.
The second defining characteristic is that during surgery to remove the tumor, the operating surgeon or pathologist can see this cancer cells by using a microscope when examining samples. These samples are taken from various sites in the abdomen, but this cancer will show itself on the outside lining of the pelvis, also called the peritoneum.
This cancer cells can now be seen by a surgeon’s naked eye, but are less than 2 centimeters in diameter. Further testing will also show that this cancer has spread further than the pelvic area, and may have found its way to the nearest lymph nodes outside the pelvis.
This cancer has now grown in diameter and can be seen with the naked eye. It has moved past the peritoneum lining and now inhabits the outside of the lining. In some cases, this cancer has already moved to the outside lining of other organs, such as the liver or spleen, and has found the lymph nodes.
Stage 3 ovarian cancer is the stage at which many women are diagnosed, with over 40% of women receiving this diagnosis. Of those who seek treatment, about 20% of women will survive this stage of ovarian cancer.
Stage 4 ovarian cancer is the last stage of this cancer’s progression. It is characterized by the presence of cancer cells near or on major organs. There are two substages.
This cancer has moved from the pelvic area and the lymph nodes and into the area around the lungs. Extra fluid holds this cancer cells at bay, so they don’t actually penetrate the lungs, but their presence here is still life-threatening. This cancer is not found in any other major organs, and is confined to the general pelvic area and the fluid around the lungs.
Cancer cells have spread to all major organs. This can include the brain, the lungs, and the skin. Treatment at this level is possible but very difficult and requires rounds of treatment.
Women who are diagnosed with stage 4 ovarian cancer have the lowest diagnosis rate — 15% of diagnosed women will be at this stage. Since stage 4 is metastatic cancer, only 5% of women will live to enjoy the five year-relative survival rate.
Types of Ovarian Cancer Cancer
There are over 30 different types of ovarian cancer that stem from three different cells that turn cancerous. These cells — surface epithelium, germ cells, and stromal cells — are all found in a woman’s reproductive system. Here is a quick overview of the cells and their relationship to ovarian cancer.
Common Epithelial Tumors
These tumors originate from the surface epithelium, the name given to the cells that coat the lining of the ovaries. Think of it as the protective covering that shields your ovaries from the fluids that are found in your abdomen.
Epithelial ovarian tumors are often noncancerous, but those that are cancerous are called carcinomas. They begin right in the tissue that lines the ovaries.
Epithelial tumors are the most common cause of ovarian cancers. They are also the most dangerous. Women with common epithelial ovarian cancer are also the most misdiagnosed, with over 70% of them not receiving a cancer diagnosis until stage 3 or stage 4.
Even though epithelial ovarian carcinomas are the cause of up to 90% of all ovarian cancers, there is much more work that needs to be done in order to understand their cause in order to provide more effective treatment.
Germ Cell Tumors
Germ cells are cells in a woman’s ovaries that have been created to form eggs. Germ cell tumors are by and large benign, except in rare cases.
These tumors are less common than epithelial tumors, but can become just as cancerous and life-threatening. Germ cell tumors are also most frequently found in young women and teens. That makes them the most common cause of ovarian cancers of women under the age of 40.
Ovarian germ cell tumors that are cancerous can be treated with a high rate of success. 90% of all patients who have ovarian cancer that stems from germ cell tumors have their fertility preserved and remain in remission.
Think of stromal cells as the network of hormones and pathways within your ovaries. They release hormones on a biological clock that is in tune with a woman’s reproductive cycle as well as connecting the different parts of the ovary. They are most commonly defined as the connective tissues that hold the ovaries together.
Stromal tumors are especially rare. These tumors original in the connective tissue that holds the ovaries together. They are also found in the tissue that produces estrogen and progesterone, both of which are female hormones.
Ovarian stromal tumors are also classed as low-grade tumors, meaning that the possibility of this cancer spreading to other parts of the body is very low. Women with ovarian stromal tumors are usually diagnosed with stage 1 ovarian cancer, and accounts for 70% of all ovarian cancer cases at this stage.
Grading Cancer Cells
Cancer cells are graded by oncologists. This means that they are looked at underneath a microscope to compare them to other normal cells within the body.
Grading cancer cells is a key factor for knowing whether or not you will need additional treatment after surgery is performed to remove the tumor. The faster this cancer cells grow, the more likely you will need treatment after your initial surgery to remove the rest of this cancer.
Low-grade cancer cells resemble normal cells and grow at a slow rate. These cancer cells are less likely to spread, meaning they lower the need for treatment after surgery is performed.
Moderate-grade cancer cells are abnormal when compared to normal cells and grow faster than normal cells. This means there is a likelihood that this cancer will spread and that further treatment may be needed after surgery.
High-grade cancer cells typically don’t resemble healthy cells at all and have an accelerated growth rate. This means that the probability of this cancer spreading to other parts of the body is extremely high. Women who have high-grade cancer cells will need extensive treatment after surgery.
(RELATED: Symtpoms, Stages & Treatments: discover everything you want to know about ovarian cancer)
Knowing the differences in stages, ovarian cancer types, and the grading of cells may help a woman understand more about this cancer she is fighting. While fighting ovarian cancer may seem tough, being informed will make the treatment process a little easier.
Source List for Stages
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- How is ovarian cancer staged? (2014, August 5). Retrieved February 29, 2016, from http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-staging
- Ovarian cancer. (2012, December 20). Retrieved February 29, 2016, from http://umm.edu/health/medical/reports/articles/ovarian-cancer
- Ovarian cancer – Diagnosis. (2015, January 21). Retrieved February 29, 2016, from http://www.nhs.uk/Conditions/Cancer-of-the-ovary/Pages/Diagnosis.aspx
- Stages and grades. (2013, February 1). Retrieved February 29, 2016, from http://www.targetovariancancer.org.uk/about-ovarian-cancer/what-ovarian-cancer/stages-and-grades
- Stages of Ovarian Cancer. (n.d.). Retrieved February 29, 2016, from https://www.mskcc.org/cancer-care/types/ovarian/diagnosis/stages
- Stages of ovarian cancer. (n.d.). Retrieved February 29, 2016, from http://www.cancerresearchuk.org/about-cancer/type/ovarian-cancer/treatment/stages-of-ovarian-cancer#stage1
- Stages of ovarian cancer – Canadian Cancer Society. (n.d.). Retrieved February 29, 2016, from http://www.cancer.ca/en/cancer-information/cancer-type/ovarian/staging/?region=qc
- What are the different stages of ovarian cancer? (n.d.). Retrieved February 29, 2016, from http://ovarian.org.uk/about-ovarian-cancer/what-is-ovarian-cancer/what-are-the-different-stages-of-ovarian-cancer