Stage 2 ovarian cancer

Stage 2 ovarian cancer means the cancer has grown outside the ovaries and is growing within the pelvis. Treatment is surgery and chemotherapy.

The stage of a cancer tells the doctor how big it is and if it has spread. The tests and scans you have to diagnose your cancer will give some information about the stage. But your doctor might not be able to tell you the exact stage until you have surgery.

Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system to stage cancers in the:  

• ovaries 
• fallopian tubes
• peritoneum

There are four stages, numbered 1 to 4. 

What is stage 2?

Stage 2 ovarian cancer means the cancer has grown outside the ovary or ovaries. And is growing within the area circled by your hip bones (the pelvis). There may also be cancer cells in the abdomen.

It is divided into 2 groups:

Stage 2A means the cancer has grown into the fallopian tubes or the womb

Stage 2B means the cancer has grown into other tissues in the pelvis, such as the bladder or bowel (rectum or sigmoid colon)

Treating stage 2 ovarian cancer

Doctors usually class stage 2 cancer as advanced ovarian cancer. This means the cancer has spread away from the ovary.

The main treatments are surgery and chemotherapy. Treatment can cure some advanced cancers. But if treatment can’t cure you, the aim of treatment is to control the cancer for as long as possible.

The specialist doctors consider several factors when deciding whether you can have surgery. And whether you should have chemotherapy before or after the operation. These include;

• where the cancer has spread to
• whether the specialist surgeon (gynaecological oncologist) thinks they can remove all the cancer 
• your general health

You might have;

• chemotherapy after surgery – this is called debulking surgery
• chemotherapy before and after surgery – doctors sometimes call this interval debulking surgery (IDS)

Chemotherapy after surgery

You have debulking surgery as your first treatment if;

• you are well enough
• the specialist surgeon thinks they can remove all the cancer.

The surgeon removes as much of the cancer as possible. After you recover from surgery, you have chemotherapy. This is adjuvant chemotherapy.

Adjuvant chemotherapy aims to reduce the risk of the cancer coming back. If the surgeon couldn't remove all the cancer, then chemotherapy aims to shrink the cancer that is left behind. Some women may then have further surgery.

Chemotherapy before and after surgery

You might have chemotherapy as your first treatment if:

• your surgeon looks at your scans and decides it isn’t possible to remove all your cancer
• you aren’t well enough for surgery straight away

This is neoadjuvant chemotherapy or primary chemotherapy. The chemotherapy aims to shrink the cancer and make it easier to remove.

You have a scan halfway through the chemotherapy course. You then have surgery if the scan shows your cancer is shrinking. You may hear your specialist call this interval debulking surgery, or IDS. After the surgery, you have the rest of the course of chemotherapy.