If ovarian cancer has reached stage 3, this means cancerous cells have spread from the ovaries or fallopian tubes to nearby tissues, such as the abdominal cavity or lymph nodes. By the time of diagnosis, 60% of cases of ovarian cancer are at stage 3.
Treatment can work successfully for stage 3 ovarian cancer, but this depends on several factors. Where the cancer has spread, a person’s general health, and how they respond to treatment will make a difference.This article looks at the symptoms and treatment of stage 3 ovarian cancer. It also explores survival and recurrence rates and the questions someone may want to ask a doctor following a diagnosis.
Ovarian cancer is a disease in which cells in the ovaries divide rapidly and abnormally, forming tumors. Cancer can begin in the ovaries themselves or the fallopian tubes. Over time, it may spread beyond its original location to other parts of the body.
There are three types of ovarian cancer:
epithelial cancer, which develops in the tissue surrounding the ovaries
stromal cancer, which develops in hormone-producing cells
germ cell cancer, which develops in egg-producing cells
Doctors use a four-stage system to describe the severity and spread of ovarian cancer, with stage 4 being the most severe. Stage 3 means that cancer has spread to nearby tissues, such as lymph nodes, but not to areas further away from the ovaries.
Doctors further divide stage 3 ovarian cancer into three substages: 3A, 3B, and 3C.
If there is cancer in one or both ovaries or fallopian tubes, and in the lymph nodes at the back of the abdomen, doctors classify this as stage 3A1. If cancer cells have spread into tissue samples from the lining of the abdomen and possibly the lymph nodes, this is stage 3A2 cancer.
At stage 3B, tumors 2 centimeters (cm) wide or smaller are present in the abdominal lining and potentially in the lymph nodes.
In stage 3C, tumors measuring more than 2 cm wide have formed in the abdominal lining, and the individual may have cancer in the lymph nodes.
Is it curable?
Yes, doctors can treat stage 3 ovarian cancer. However, it is more difficult to treat than stages 1 and 2.
Cancer treatment aims to achieve remission, which means that the signs and symptoms of the cancer are partially or completely gone. If someone enters complete remission for 5 years or more, doctors may say their cancer is cured.
Ovarian cancer can cause a range of symptoms, but many early signs are easy to overlook. Ovarian cancer may cause:
problems eating or feeling full too quickly
needing to urinate frequently or urgently
Many conditions can cause similar symptoms. However, with cancer, these symptoms are likely to be persistent. Additional symptoms people may experience at stage 3 include:
Changes in bowel habits: Constipation and diarrhea, stomach cramps, vomiting, and possible bowel obstruction owing to tumor growth.
Pain during sexual intercourse: The individual may notice pain on one side or generalized pain similar to menstrual cramps during penetrative sex.
Back pain: People may experience pain in the lower back or between the rib cage and hip. Again, this can resemble menstrual pain.
Unintentional weight changes: People may gain weight due to an accumulation of abdominal fluid. Conversely, they may lose weight due to lack of appetite or cancer cachexia, a syndrome that causes people to lose weight and muscle mass.
Fluid in the abdomen: This occurs when cancer in the abdomen and liver causes a large volume of fluid to build up. This fluid can press on the lungs, creating breathing difficulties. A doctor may need to drain the fluid.
Fatigue: As stage 3 ovarian cancer progresses, the number of cancer cells increases. This process uses up energy and may cause persistent fatigue, or lack of energy.
The primary way doctors treat ovarian cancer is through surgery, accompanied by combination chemotherapy if required.
During surgery, medical professionals can remove as many cancerous cells as possible and determine the cancer stage by taking tissue samples. The more tumors they can remove, the better the chance of treatment being successful.
Often, surgery for ovarian cancer involves removing the ovaries, fallopian tubes, and uterus. The surgery to remove the ovaries and fallopian tubes is called a salpingo-oopherectomy. Removing the uterus is known as a hysterectomy. Undergoing either procedure will mean a person can no longer get pregnant.
A surgeon may also take samples from other tissues around the abdomen or lymph nodes to test for signs that cancer has spread farther afield. Based on this, a cancer specialist can confirm that the disease is at stage 3.
After surgery, treatment typically involves chemotherapy, sometimes in combination with targeted drugs. This shrinks and kills any remaining cancer cells left over after the surgery.Some people may receive intraperitoneal (IP) chemotherapy. A healthcare professional will place IP chemotherapy directly into the abdominal cavity, applying a high concentration directly onto the cancer cells.
A 5-year relative survival rate measures how likely a person with cancer is to survive for at least 5 years compared with the rest of the population. When tracking survival rates, the Surveillance, Epidemiology and End Results (SEER) database groups cancer into three categories:
Localized cancer is limited to a specific part of the body, such as the ovaries.
Regional cancer has spread to nearby tissues or lymph nodes.
Distant cancer has spread to parts of the body far from the original cancer site.
From 2010–2016, the 5-year relative survival rates for people with invasive epithelial ovarian cancer were as follows:
93% for localized cases
75% for regional cases
31% for distant cases
The rates for people with ovarian stromal tumors were:
98% for localized cases
89% for regional cases
60% for distant cases
Individuals with germ cell tumors of the ovary have the following 5-year relative survival rates:
98% for localized cases
94% for regional cases
73% for distant cases
People with fallopian tube cancer have rates of:
95% for localized cases
53% for regional cases
45% for distant cases
Keep in mind that these figures are averages and do not reflect what will happen in each individual case. The SEER statistics are also based on data that are not entirely up to date.
Even if ovarian cancer enters remission, there is a possibility it can come back. This is known as recurrence. According to OCRA, stage 3 ovarian cancer has a 70–90% chance of recurring.
Recurrent ovarian cancer is treatable, but it is difficult to cure completely. Treatment via chemotherapy can reduce its growth and alleviate symptoms. Surgeons can also remove tumors that are causing additional complications, such as by blocking the digestive tract.For aggressive cancers that resist common treatment types, people may be able to enroll in clinical trials to try newer approaches.
Questions to ask a doctor
It is important to understand all the options for ovarian cancer treatment. Some questions a person may want to ask an oncologist, or gynecologist oncologist, include:
What type of ovarian cancer do I have?
What is the exact stage of the cancer?
Do I need tests?
What treatment do you recommend, and why?
What is the goal of treatment?
How soon do I need to decide which treatment options to choose?
If I need surgery, is there a way to preserve fertility?
What are the possible side effects or complications of treatment?
Are there any activities I should avoid during or after treatment?
How will a hysterectomy or salpingo-oopherectomy affect the rest of my life?
How will you know if treatment has worked?
A cancer diagnosis is often an overwhelming experience, and people benefit from having a robust support network. Organizations that offer helpful information and advice include:
the National Ovarian Cancer Coalition, which runs online support groups and helps individuals find compassionate support
the American Cancer Society, which links to support groups and has resources on paying for treatment, including any transport or accommodation required
the National Cancer Institute, which has a database of nationwide cancer services
Stage 3 ovarian cancer is considered an advanced stage of cancer. At this point, the cancerous cells have spread beyond the ovaries and fallopian tubes into nearby tissues. Within stage 3, three substages further classify how far the disease has progressed.Treatment typically involves surgery to remove as much of the cancer as possible, before moving on to chemotherapy to shrink and kill remaining cancer cells. Recurrence is common, but every case is different.