Staging of ovarian cancer is important, as it influences treatment and determines likely prognosis, according to the American Cancer Society. Once a stage is determined, it does not change even if the cancer comes back or spreads. Staging is based on tumor size, the absence or presence of positive lymph nodes and whether the cancer has spread to other organs. Staging is determined in surgery, during which the ovaries, fallopian tubes, uterus and lymph nodes are removed. The surgeon will also do washings of the abdomen and pelvis. This means that fluid will be swished around in the abdominal and pelvic cavity and sent to pathology to be looked at under a microscope for cancer cells. Symptoms during each stage can vary. Because early ovarian cancer displays non-specific symptoms, it is often not caught until the later stages.
Stage I
Many women have non-specific symptoms during this stage. Stage I ovarian cancer means that the cancer is contained in one or both ovaries and there is no sign of it on the outside shell of the ovary. Advanced stage I cancer indicates that the cancer is contained but one or more of the following is present: cancer shows on the outer surface of the ovary or cancer cells were found under the microscope in the washings of the abdominal wall and pelvis. According to MayoClinic.com, women may have abdominal pressure, a sense of fullness, urinary urgency, pelvic pain and persistent indigestion.
Stage II
Stage II ovarian cancer means that the cancer is in one or both of the ovaries and has involved the other organs of the pelvis such as the colon, bladder, fallopian tubes and uterus. Late stage II disease means that the cancer is in one or both of the ovaries and abdominal washings are positive. Symptoms during this stage could include low back pain, dyspareunia or painful sex, change in bowel or bladder habits, increased gas or indigestion and irregular menses.
Stage III
Stage III ovarian cancer means that there is cancer in one or both ovaries but it has spread to the abdominal wall or into the lymph nodes. Late stage III cancer means that one or both ovaries have cancer and that there are deposits of cancer visible to the naked eye on the lymph nodes that are greater than 2 cm in length. Symptoms during this stage could include increased abdominal girth, lack of energy and any of the symptoms in the first two stages.
Stage IV
This is the most advanced stage of ovarian cancer. The cancer is not only in the ovaries and the abdominal wall but it has spread to the lungs, liver or other organs. The patient may have increased fluid around the lungs called a pleural effusion at this stage of the cancer.
