Ovarian Epithelial Cancer Treatment - Stages of Ovarian Epithelial Cancer

After ovarian cancer has been diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body.

The process used to find out whether cancer has spread within the ovaries or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose ovarian cancer are often also used to stage the disease. (See the section.)

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:
  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Cancer may spread from where it began to other parts of the body.

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if ovarian epithelial cancer spreads to the lung, the cancer cells in the lung are actually ovarian epithelial cancer cells. The disease is metastatic ovarian epithelial cancer, not lung cancer.

The following stages are used for ovarian epithelial cancer:

Stage I


Three-panel drawing of stage IA, IB, and IC ovarian cancer; first panel shows a stage IA tumor inside one ovary. The second panel shows two stage IB tumors, one inside each ovary. The third panel shows two stage IC tumors, one inside each ovary, and one tumor has a ruptured capsule. An inset shows cancer cells floating in the peritoneal fluid surrounding abdominal organs. Also shown are the fallopian tubes, uterus, cervix, and vagina.
Ovarian cancer stage IA, IB, and IC. In stage IA, cancer is found inside a single ovary. In stage IB, cancer is found inside both ovaries. In stage IC, cancer is found in one or both ovaries and one of the following is true: (a) cancer is found on the outside surface of one or both ovaries, (b) the capsule (outer covering) of the ovary has broken open, or (c) cancer cells are found floating in the peritoneal fluid surrounding abdominal organs or in washings of the peritoneum.
In stage I, cancer is found in one or both ovaries. Stage I is divided into stage IA, stage IB, and stage IC.

Stage II


Three-panel drawing of stage IIA, IIB, and IIC ovarian cancer; first panel shows two stage IIA tumors, one inside each ovary, that have spread to the uterus and fallopian tube. The second panel shows two stage IIB tumors, one inside each ovary, that have spread to the uterus, fallopian tube,  and  colon. The third panel shows two stage IIC tumors, one inside each ovary, that have spread to the uterus and colon. An inset shows cancer cells floating in the peritoneal fluid surrounding abdominal organs. Also shown are the cervix and vagina.
Ovarian cancer stage IIA, IIB, and IIC. In stage IIA, cancer is found inside one or both ovaries and has spread to the uterus and/or the fallopian tubes. In stage IIB, cancer is found inside one or both ovaries and has spread to other tissues within the pelvis. In stage IIC, cancer is found inside one or both ovaries and has spread to the uterus and/or fallopian tubes and/or other tissue within the pelvis, and one of the following is true: (a) cancer is found on the outside surface of one or both ovaries, (b) the capsule (outer covering) of the ovary has broken open, or (c) cancer cells are found floating in the peritoneal fluid surrounding abdominal organs or in washings of the peritoneum.
In stage II, cancer is found in one or both ovaries and has spread into other areas of the pelvis. Stage II is divided into stage IIA, stage IIB, and stage IIC.

    Tumor size compared to everyday objects; shows various measurements of a tumor compared to a pea, peanut, walnut, and lime
    Pea, peanut, walnut, and lime show tumor sizes.

    Stage III

    In stage III, cancer is found in one or both ovaries and has spread outside the pelvis to other parts of the abdomen and/or nearby lymph nodes. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC.
    • Stage IIIB: Cancer has spread to the peritoneum and the cancer in the peritoneum is 2 centimeters or smaller.
      Stage IIIB ovarian cancer; drawing shows tumors inside both ovaries that have spread to the uterus, colon, small intestine, and the peritoneum, where they are 2 centimeters or smaller in diameter. An inset shows 2 centimeters is about the size of a peanut. Also shown are the fallopian tubes and bladder.
      Stage IIIB ovarian cancer. In stage IIIB, cancer is found in one or both ovaries and has spread to other tissue within the abdomen and to the peritoneum, where it is 2 centimeters or smaller in diameter. Cancer that has spread to the surface of the liver is also considered to be stage III.
    Cancer that has spread to the surface of the liver is also considered stage III ovarian cancer.

    Stage IV


    Stage IV ovarian cancer; drawing shows parts of the body where ovarian cancer may spread, including the liver, lung, lymph nodes, and bone. An inset shows a close-up of cancer spreading through the blood and lymph to other parts of the body.
    Stage IV ovarian cancer. Cancer is found in one or both ovaries and may spread to other parts of the body, such as the lymph nodes, lung, liver, and bone. Cancer cells may also be found in an area between the lungs and the chest wall that has filled with fluid.
    In stage IV, cancer has spread beyond the abdomen to other parts of the body, such as the lungs or tissue inside the liver. Cancer cells in the fluid around the lungs is also considered stage IV ovarian cancer.