How Ovarian Cancer Is Treated in Stages I & II

One in 78 women will be diagnosed with ovarian cancer. Women may be at risk due to a number of factors: family/personal history of breast, ovarian or colorectal cancer; inheritance of certain gene mutations; being between ages 50 and 60; obesity; taking hormone replacement therapy (HRT); menstruating early or experiencing menopause late. Treatment varies by patient characteristics and stage of the cancer. Options include surgery—removing one or both ovaries and sometimes the fallopian tubes, uterus and lymph nodes—chemotherapy and targeted therapies, primarily in recurrent cases.

Prognosis for early cases

Ovarian cancer is categorized in stages progressing from I to IV. In early stages, it is very treatable. Though prognosis differs from patient to patient, the five-year relative survival rate for early-stage patients is 93 percent—meaning, on average, they are about 93 percent as likely as people who don't have ovarian cancer to live for at least five years after being diagnosed. However, keep in mind survival rates are individualistic; generating an accurate rate requires incorporation of patient characteristics and understanding the stage and grade of the cancer, and the type of ovarian cells affected.

Treatments for stage I

Stage I ovarian cancer can be divided into stages: IA (affecting only one ovary or fallopian tube), IB (affecting both ovaries or fallopian tubes but not beyond) and IC (affecting the ovaries or fallopian tubes and the outer surface or occurring in a burst outer capsule). According to the American Cancer Society, only 15 percent of ovarian cancer cases are diagnosed in stage I. Invasive epithelial ovarian cancer has a relative survival rate of 93, 91 and 84 percent for stages IA, IB and IC, respectively. Ovarian stromal and germ cell tumors have even better rates, at 98 percent.

In the earliest stage of cancer, treatment typically includes excision, or removal, of the tumor. The cancer grade—how abnormal cancer cells look under a microscope—also informs treatment, and women with grade 1 (least abnormal) may not even need surgery. For those who do, removal of only one ovary may be necessary, though removal of the fallopian tubes, lymph nodes and uterus may also be recommended. After surgery, chemotherapy may be recommended, such as a round of carboplatin and paclitaxel for three to six cycles. Radiation may also be an option to kill any remaining cancer cells and reduce chances of recurrence.

Treatments for stage II

Stage II cancers, which have spread beyond the ovaries or fallopian tubes to impact elsewhere in the pelvis, are classified as either IIA, IIB or IIC. IIA cancers have spread from the ovaries to the fallopian tubes and/or uterus; IIB indicates spread to neighboring organs, such as the bladder, colon or rectum; IIC denotes the presence of additional cancer cells on the outside of ovaries or in peritoneal cavity fluid (abdominal fluid), or the rupture of an ovary. An estimated 19 percent of ovarian cancer cases are discovered in stage II, with relative five-year survival rates of 78, 73 and 57 percent for stages IIA, IIB and IIC, respectively.

Treatment for stage II often requires hysterosalpingo-oophorectomy, surgical removal of the uterus, ovaries and fallopian tubes. Six or more cycles of chemotherapy typically follow. Intraperitoneal (IP) chemotherapy may be recommended in lieu of intravenous (IV) delivery.

Detecting cancer early

Women can maximize the odds of beating ovarian cancer by looking out for early signs and symptoms—abdominal or pelvic pain or cramping, bloating, feeling full quickly, increased urinary urgency or frequency—and following recommendations for screening. For women with average risk, this means regular pelvic exams during a gynecology visit. Women with a relative risk, including those with inherited risk, of three to six times or more than that of the general public may be recommended for serum marker screening and transvaginal ultrasound, beginning as early as age 35. If you notice any worrying symptoms, make an appointment with your doctor immediately for further evaluation.

Amazing advancements have been made in cancer medicine. If you are diagnosed with ovarian cancer, do your research and work with your doctor (and your loved ones) to develop the best possible plan of attack.