Ovarian Cancer

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Questions to Ask Your Doctor about Ovarian Cancer
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Ovarian Cancer Staging

When ovarian cancer is suspected, patients usually undergo an exploratory laparotomy to determine the stage of the disease (i.e., how far it has spread). During exploratory laparotomy, the physician (usually a gynecologic oncologist) makes an incision through the abdomen to the ovaries.

If cancer is detected, the physician removes as much of the tumor as possible. The extent of surgery depends on the type of cancer and how far it has spread. In some cases, one ovary is removed in a procedure called unilateral oophorectomy. Usually, the physician removes both ovaries, the uterus, the fallopian tubes, and the omentum (fatty tissue that covers the bowels).

A biopsy (sample of tissue for microscopic evaluation) of pelvic and abdominal lymph nodes (small glands that filter out infectious organisms) may be performed. Finally, the abdominal cavity is "washed" with fluid that is then collected and examined under a microscope for cancer cells (called peritoneal lavage).

To stage the cancer, the physician reviews the histopathology report from the samples obtained during laparotomy, as well as results from needle biopsy, blood tests, imaging studies, or other tests. Staging provides an estimate of disease-free survival, overall survival, and the risk for recurrence or relapse. Staging also helps the physician and patient to choose appropriate treatment(s).

Staging System

Stage I:	Ovarian cancer that is confined to one or both ovaries.
Stage II:	Ovarian cancer that has spread to pelvic organs (e.g., uterus, fallopian tubes), but has not spread to abdominal organs.
Stage III:	Ovarian cancer that has spread to abdominal organs (e.g., abdominal lymph nodes, liver, bowel).
Stage IV:	Ovarian cancer that has spread outside to distant sites (e.g., lung, brain, lymph nodes in the neck).
Recurrent:	Ovarian cancer that has recurred (come back) even though the patient has completed treatment.

Once ovarian cancer is assigned a stage, the classification does not change, even if the cancer recurs or metastasizes to other sites within the body.

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