Stages of Ovarian Cancer and What Each Means for You
If you’ve recently been diagnosed with ovarian cancer, your cancer was probably “staged” by your oncologist.
The staging indicates if and where your ovarian cancer has spread and gives an indicator of the prognosis of the cancer. Although it may seem impersonal, it is a useful tool for the physicians treating you.
According to the American Joint Committee on Cancer (AJCC), cancer staging is not only important because it describes the amount of cancer in the body and the location, but also the severity of the cancer – “based on the magnitude of the original (primary) tumor as well as on the extent cancer has spread in the body.”
Having this information allows oncologists to tailor a treatment plan that is specific to the individual patient, and develop a prognosis.
Staging is also useful because it offers information. This information is helpful to any physician who understands the staging system and allows them to “effectively communicate about a patient’s cancer and collaborate on the best courses of treatment.”
How Ovarian Cancer Is Staged
While your cancer may have been diagnosed in a variety of ways, staging the cancer typically is done during surgery by taking tissue samples from different areas and assessing for cancer cells — the presence of cancer cells indicate that the cancer has spread.
Not only is staging important because it indicates if and where the cancer has spread, but it also gives your oncologist a clue as to how to best treat your cancer.
It is important to note that the stage of your cancer does not change; the stage will always be the stage at diagnosis, even if the cancer metastasizes to different areas or if it recurs after remission.
The Various Types of Staging
The AJCC notes that there are four different types of staging; the first type is used at initial diagnosis of ovarian cancer:
- Clinical staging: determines the how much cancer there is based on biopsies of the area, physical examination, and any other diagnostic tests that may have been performed.
- Pathologic staging: this staging is combined with the results of clinical staging. Pathologic staging can only be determined if the individual has had the tumor removed or surgery to explore the extent of their tumor.
- Post-therapy or post-neoadjuvant therapy staging: this determines the extent of cancer that remains after the patient is treated with a systemic treatment (such as chemotherapy) and/or radiation.
- Restaging: is used when cancer returns after treatment.
FIGO System
Although there are different methods of staging ovarian cancer, the most common is the FIGO system. The FIGO system assigns letters to the stage based on the findings of the biopsies obtained during surgery.
The extent of the tumor uses the letter T. The absence or presence of metastasis uses the letter M. The presence of cancer in nearby lymph nodes uses the letter N. This information is compiled and used to determine the final stage.
Stage I
The cancer has not spread outside of the ovaries and/or fallopian tubes. The following are further used to describe this stage of ovarian cancer:
Stage IA (T1a, N0, M0): cancer is in one ovary or fallopian tube.
Stage IB (T1b, N0, M0): cancer is in both ovaries or fallopian tubes but not on the outer surfaces.
Stage IC (T1C, N0, M0): the cancer is in both ovaries or fallopian tubes. In addition:
- IC1: the capsule surrounding the tumor broke, allowing the possibility of cancer cells to leak into the abdomen and pelvis.
- IC2: cancer is on the outer surface of the ovaries or fallopian tubes.
- IC3: cancer cells are in the fluid of the abdomen.
The survival rate for stage I cancers is promising:
- I: 90 percent
- IA: 94 percent
- IB: 92 percent
- IC: 85 percent
Stage II
The cancer has spread to other organs, but the spread is limited to the pelvis. This may include the bladder, the colon, and the rectum. Lymph nodes or distant sites are not involved.
Stage IIA (T2a, N0, M0): cancer has spread into the uterus
Stage IIB (T2b, N0, M0): cancer has spread to other pelvic organs, such as the rectum.
Survival rates for this stage are:
- II: 70 percent
- IIA: 78 percent
- IIB: 73 percent
