Differences Between Early and Advanced Ovarian Cancer

The main difference between early and advanced ovarian cancer is the size of the tumor and the spread of the cancer. A few other factors also play a role.

Generally, cancer that has spread outside of the ovaries is called advanced ovarian cancer. There are 4 main stages of ovarian cancer: stages I, II, III, and IV. Stages II through IV are considered “advanced.”

Location

In early-stage ovarian cancer, the cancer is in the ovaries or fallopian tubes. In some cases, cancer may also be found on the outside of the ovaries or in fluid or washings from the abdomen and pelvis. This is considered stage IC. There is no cancer in lymph nodes or distant sites in the body.¹

Starting in stage II, cancer may be found in other pelvic organs. There may also be primary peritoneal cancer. This is cancer that starts in the thin layer of tissue lining the inside of the abdomen.¹

Ovarian cancer that is stage II through stage IV is advanced ovarian cancer. This is ovarian cancer that has spread (metastasized). Stage IV is ovarian cancer that has spread to fluid around the lungs, distant lymph nodes, or organs outside the peritoneal cavity.¹

How cases are counted and tracked

The National Cancer Institute has a database called SEER. This stands for the Surveillance, Epidemiology, and End Results Program. It collects cancer statistics and tracks people in the United States who are diagnosed with cancer. The database also collects information on:²

• Who gets the disease
• Where they live
• Stage of their disease
• Treatment they get
• Mortality statistics

People living with the disease

The SEER database estimates that about 21,750 people in the United States were diagnosed with ovarian cancer in 2020.³

The American Cancer Society estimates that in 2021, about 21,410 women will get a new diagnosis of ovarian cancer. About 13,770 will die from the condition.⁴

Ovarian cancer is the fifth leading cause of cancer deaths in women. It causes more deaths than any other cancer of the female reproductive system.⁴

Survival rates

Many people with stage I ovarian cancer have a very good prognosis. As with most cancers, the earlier ovarian cancer is found, the easier it is to treat.

Nearly half (46.2 percent) of people with ovarian cancer – diagnosed at any stage – are alive at least 5 years after diagnosis. Survival rates by overall stage are as follows:⁵

• Stage I: 90 percent
• Stage II: 70 percent
• Stage III: 39 percent
• Stage IV: 17 percent

Treatment goals

For early-stage ovarian cancers, the goal is to remove the tumor. Any further treatment depends on the sub-stage of the cancer. This provides more information about how big the tumor was and where cancer cells were found. Treatment following surgery usually includes chemotherapy.⁶

For advanced ovarian cancers in stages II and III, surgery for staging and debulking is done first. This is to remove as much of the cancer as possible. After surgery, treatment usually includes at least 6 cycles of chemotherapy.⁶

In stage IV ovarian cancer, the cancer is very hard to cure since it has spread to distant parts of the body. However, these cancers can still be treated. Treatment focuses on controlling spread, relieving symptoms, and extending life. These cancers can be treated with surgery and chemotherapy, or palliative care only.⁶