If you’ve been diagnosed with ovarian cancer, you’re probably wondering about your prognosis. While knowing your prognosis can be helpful, it’s only a general guideline. Your individual outlook will depend on many factors, such as your age and overall health.
ovarian cancer is staged and what it means
One of the first things you’ll want to know is the stage of your ovarian cancer. Staging is a way of describing how far the cancer has spread and can indicate how aggressive your cancer is. Knowing the stage helps doctors formulate a treatment plan and gives you some idea of what to expect.
Ovarian cancer is primarily staged using the FIGO (International Federation of Gynecology and Obstetrics) staging system. The system is based mainly on a physical exam and other tests that measure:
- the size of the tumor
- how deeply the tumor has invaded tissues in and around the ovaries
- the cancer’s spread to distant areas of the body (metastasis)
If surgery is performed, it can help doctors more accurately determine the size of the primary tumor. Accurate staging is important in helping you and your doctor understand the chances that your cancer treatment will be curative.
These are the four stages for ovarian cancer:
In stage 1, the cancer has not spread beyond the ovaries. Stage 1A means the cancer is only in one ovary. In stage 1B, the cancer is in both ovaries. Stage 1C means that one or both ovaries contain cancer cells and one of the following are also found: the outer capsule broke during surgery, the capsule burst before surgery, there are cancer cells on the outside of an ovary, or cancer cells are found in fluid washings from the abdomen.
In stage 2 ovarian cancer, the cancer is in one or both ovaries and has spread to elsewhere within the pelvis. Stage 2A means it has gone from the ovaries to the fallopian tubes, the uterus, or to both. Stage 2B indicates the cancer has migrated to nearby organs like the bladder, sigmoid colon, or rectum.
In stage 3 ovarian cancer, the cancer is found in one or both ovaries, as well as in the lining of the abdomen, or it has spread to lymph nodes in the abdomen. In Stage 3A, the cancer is found in other pelvic organs and in lymph nodes within the abdominal cavity (retroperitoneal lymph nodes) or in the abdominal lining. Stage 3B is when the cancer has spread to nearby organs within the pelvis. Cancer cells may be found on the outside of the spleen or liver or in the lymph nodes. Stage 3C means that larger deposits of cancer cells are found outside the spleen or liver, or that it has spread to the lymph nodes.
Stage 4 is the most advanced stage of ovarian cancer. It means the cancer has spread to distant areas or organs in your body. In stage 4A, cancer cells are present in the fluid around the lungs. Stage 4B means that it has reached the inside of the spleen or liver, distant lymph nodes, or other distant organs such as the skin, lungs, or brain.
Your prognosis depends on both the stage and the type of ovarian cancer you have.
There are three types of ovarian cancer:
- Epithelial: These tumors develop in the layer of tissue on the outside of the ovaries.
- Stromal: These tumors grow in hormone-producing cells.
- Germ cell: These tumors develop in egg-producing cells.
According to the Mayo Clinic, about 90 percent of ovarian cancers involve epithelial tumors. Stromal tumors represent about 7 percent of ovarian tumors, while germ cell tumors are significantly rarer.
The five-year relative survival rate for these three types of tumors is 44 percent, according to the American Cancer Society.
Early detection generally results in a better outlook. When diagnosed and treated in stage 1, the five-year relative survival rate is 92 percent. Only about 15 percent of ovarian cancers are diagnosed in stage 1.
Below is the relative five-year survival rate for epithelial ovarian cancer:
Below is the relative five-year survival rate for ovarian stromal tumors:
Below is the relative five-year survival rate for ovarian germ cell tumors:
The Surveillance, Epidemiology, and End Results (SEER) registry program of the National Cancer Institute (NCI) is the authoritative source on cancer survival in America. It collects comprehensive information for different types of cancer in populations within the United States.
The table below is derived from the SEER registry and can help you better understand the rate of survival for your stage of ovarian cancer for each year after diagnosis. Registries use a simplified approach to staging. It roughly correlates with the other staging systems as follows:
- Localized: Cancer is limited to the place where it started, with no sign that it has spread. This correlates roughly with Stage 1 disease.
- Regional: Cancer has spread to nearby lymph nodes, tissues, or organs. This encompasses Stage 2 and 3 disease described above.
- Distant: Cancer has spread to distant parts of the body. This indicates stage 4 disease.
Since fewer women have stage 1 or “localized” ovarian cancer, the overall prognosis for regional or distant disease can be broken down by year since diagnosis. For example, taking all tumor types, for women with distant spread (or stage 4 disease) of ovarian cancer, the percentage of women in the U.S. population surviving 1 year is nearly 69%.
Time Since Diagnosis
For more details, including a visual graph, see the SEER registry of survival rates for ovarian cancer by stage and time since diagnosis.
A woman’s lifetime risk of developing ovarian cancer is about 1.3 percent.
In 2016, an estimated 22,280 women in the United States alone will have received a diagnosis for ovarian cancer, and the disease will have caused 14,240 deaths. This represents about 2.4 percent of all cancer deaths.