When ovarian cancer is diagnosed, it is staged. Staging involves using a standardized classification to describe the spread and extent of a cancer. This helps to guide treatment options and prognosis. For ovarian cancer, stages range from Stage I, where the cancer is contained in the ovaries, to Stage IV, where cancer has spread to distant sites.
Significance
The National Cancer Institute estimates that in 2009 in the United States, approximately 21,550 new diagnoses of ovarian cancer were made, and that same year, 14,600 individuals died from the disease.
Features
Stage IV ovarian cancer is the most advanced stage of the disease. The American Cancer Society describes this stage as being diagnosed when the cancer has spread to the inside tissues of the liver, the lungs or distant organs outside the abdominal cavity. If there is fluid surrounding the lungs, called pleural effusion, with cancer cells in the fluid, this is also considered Stage IV ovarian cancer.
Diagnosis
If ovarian cancer is suspected, tests to confirm the diagnosis will be performed, including a CT scan, ultrasound, MRI, PET scan and biopsy. Although biopsies are typically done during surgery, a needle aspiration of fluid in the abdomen called ascites, can help diagnose cancer. Blood tests are generally done, including one called a CA-125, which is a tumor marker for ovarian cancer and is usually significantly raised in women with the disease.
Treatment
Treating Stage IV ovarian cancer generally consists of surgery, with or without additional treatment, according to the National Cancer Institute. Surgery involves removing the tumor; total hysterectomy and oophorectomy, which is the removal of the uterus and ovaries; and an omentectomy, which is the removal of the omentum, a layer of abdominal cavity lining. If 1cm or less of tumor remains after surgery, combination chemotherapy using two or more drugs is generally given. If the amount of residual cancer is more than 1cm, treatment can involve several options, including combination chemotherapy and various clinical trials of biologic therapy or second-look surgery, according to the National Cancer Institute.
Time Frame
Survival rates for cancer are marked by the five-year survival rate, which is the percentage of individuals still alive five years post-diagnosis. For Stage IV ovarian cancer, the five-year survival rate is 18 percent, according to the American Cancer Society.
