Staging and grading ovarian cancer

woman with doctor

What are the grades of ovarian cancer?

Grading describes how quickly the cancer may grow and spread. Usually the higher the grade, the more quickly the cancer is likely to grow.

  • Grade 1 or low grade (well differentiated): The cancer cells are very like normal cells in your ovary. They usually grow slowly and are less likely to spread.
  • Grade 2 or moderate grade (poorly differentiated): The cancer cells look less like normal ovarian cells.
  • Grade 3 or high grade: The cancer cells are very unlike normal ovarian cells. They usually grow quicker and are more likely to spread. 
ovarian cancer diagram

Grading describes the cancer cells – what they look like and how they might grow.

Staging describes where the cancer is in your body.

What are the stages of ovarian cancer?

Staging means finding out how big the cancer is and if it has spread to other parts of your body. Staging will help your doctor to plan the best treatment for you. Sometimes your cancer will only be staged after surgery. 

The stages of ovarian cancer are usually numbered 1 to 4 and can be further subdivided into A and B.

A higher number, such as stage 4, means a more serious cancer.

Stage 1: Cancer cells are only found in your ovaries.

  • Stage 1a – The cancer is in one ovary only.
  • Stage 1b – The cancer is in both ovaries.
  • Stage 1c – There is fluid with cancer cells in your abdomen (ascites).

Stage 2: Cancer cells have spread outside the ovary but are still within your pelvis.

  • Stage 2a – The cancer cells have spread to organs near your ovary, such as your vagina, womb or fallopian tubes.
  • Stage 2b – The cancer has spread to other organs in your pelvis, such as your lower bowel or bladder.
  • Stage 2c – The cancer has spread to other organs in your pelvis. Some fluid with cancer cells may be within your pelvis.

Stage 3: The cancer has spread outside your pelvis and into your abdominal cavity.

  • Stage 3a – The cancer in your abdomen is tiny and can only be seen under a microscope.
  • Stage 3b – The cancer in your abdomen can be seen but is smaller than 2cm across.
  • Stage 3c – The cancer in your abdomen is larger than 2cm.

Stage 4: Cancer cells have spread to other body organs and tissues. 

For example, lungs, liver or lymph nodes in your armpit or neck.

Recurrent ovarian cancer
This means that the cancer has come back (recurred) after treatment.

Staging can be hard to understand, so ask your doctor and nurse for more information if you need it.

For more information

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