Stages and grades
The stage of a cancer tells you 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.
Stage 4 ovarian cancer has spread to other parts of your body organs such as the liver or lungs. The main treatments are chemotherapy and surgery.
Staging can be complicated. Talk to your specialist doctor or nurse if you are unsure. They can help you understand more about your cancer stage.
Read more about the stages and grades of ovarian cancer
Stage 4 ovarian cancer has spread to distant body part such as the liver or lungs.
It is divided into 2 groups:
Stage 4a means the cancer has caused a build up of fluid in the lining of the lungs (the pleura). This is called a malignant pleural effusion.
Stage 4b means the cancer has spread to:
the inside of the liver or spleen
outside the tummy (abdomen)
other organs such as the lungs
Treatments for stage 4 ovarian cancer include:
surgery
chemotherapy
targeted cancer drugs
radiotherapy
Your healthcare team consider several factors when deciding what treatment you need. These include:
where the cancer has spread to
whether the specialist surgeon (gynaecological oncologist) thinks they can remove all the cancer
your general health
Your specialist surgeon (gynaecological oncologist) will remove:
both ovaries
fallopian tubes
your womb (including the cervix)
They will also check where the cancer has spread to in your pelvis and if it is in your lymph nodes. Your gynaecological oncologist will aim to remove as much of the cancer as possible.
This is called cytoreductive surgery. You may also hear it called debulking surgery.
Find out more about surgery for ovarian cancer
You might have:
chemotherapy after surgery – this is called adjuvant chemotherapy with cytoreductive surgery
chemotherapy before and after surgery – this is called neoadjuvant chemotherapy with interval cytoreductive surgery
chemotherapy into your abdomen during surgery – this is called hyperthermic intraperitoneal chemotherapy or HIPEC
Your healthcare team will discuss the best treatment for you. When you have chemotherapy will depend on your individual case.
Read about chemotherapy for ovarian cancer
Some people may have treatment with a targeted cancer drug. This will depend on your situation. You might have a targeted cancer drug:
with chemotherapy
on its own after chemotherapy
Find out about targeted cancer drugs for ovarian cancer
It might not be possible to have surgery if your cancer has spread widely or you are not well enough.
You may have chemotherapy on its own to shrink the cancer as much as possible and to slow its growth.
You might have other treatments to help relieve your symptoms. This could be treatment for fluid in the abdomen (ascites) or for a blocked bowel. Or radiotherapy to relieve symptoms like pain.
Read about treating the symptoms of advanced ovarian cancer
Researchers are always trying to improve the treatment and quality of life for people with ovarian cancer.
Find out more about research into ovarian cancer
Last reviewed: 02 Dec 2024
Next review due: 02 Dec 2027
Ovarian cancer is when abnormal cells in the ovary grow and divide in an uncontrolled way.
Most ovarian cancers start in the cells covering the ovaries and are called epithelial ovarian cancers. Other rare types include germ cell tumours, stromal tumours and sarcomas.
The main treatments for ovarian cancer are surgery and chemotherapy. Your treatment depends on several factors including your cancer stage and grade.
There is support available to help you cope with a diagnosis of ovarian cancer, life during treatment and life after cancer.
Ovarian cancer survival depends on many factors including the stage and type of your cancer.
Ovarian cancer is when abnormal cells in the ovary, fallopian tube or peritoneum begin to grow and divide in an uncontrolled way.
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