Stage 3 Ovarian Cancer

What is Stage 3 Ovarian Cancer?

Stage three ovarian cancer is considered an advanced stage where cancer has spread outside the area, which is considered the true pelvis, to nearby lymph nodes or the abdominal cavity.

What are the Subtypes of Stage 3 Ovarian Cancer?

Different types of ovarian cancer are classified by the type of cells the tumor originates from. There are over thirty types of Ovarian Cancer. However, 85 to 90 percent of Ovarian cancers originate from the cells making the outer layer of the ovaries, the epithelial cells, and is called epithelial ovarian carcinoma.[¹]

There are three common subtypes of epithelial ovarian carcinoma, with a few other rarer types occurring:[¹],[²]

Serous Carcinoma (occurrence~52% of all epithelial ovarian carcinomas) -further divided into low or high-grade serous carcinoma
Endometrioid carcinomas (occurrence~8-15% of all ovarian carcinomas)
Mucinous carcinomas (occurrence~6% of ovarian cancer cases)

Other than epithelial ovarian carcinoma, stromal and germ cell cancers also occur but much more rarely.

Stage 3 Ovarian Cancer staging and diagnosis

Ovarian Cancer staging

In general, the TNM system is used to describe and classify cancers, including Ovarian Cancer, where:

T (tumor) describes the size and location of the tumor
N (nodes) indicates whether or not it has spread to nearby lymph nodes
M (metastasis) describes if and how far the cancer has spread from its origin

How common is stage 3 Ovarian Cancer?

There were 313,000 new cases of ovarian cancer in 2020. Ovarian cancer is the eighth most common cancer in women and the eighteenth most common cancer overall. [⁴]

How is stage 3 Ovarian Cancer diagnosed?

60% of ovarian cancer cases are diagnosed at stage 3. However, it can be caught early. If your doctor notices something concerning during a pelvic exam or suspects ovarian cancer after hearing your symptoms or medical history, they will recommend the following tests or screenings, especially if you are tall, older, never bore children, or breastfed, overweight, have taken hormone therapy after menopause, have irregular periods, have a family history of the disease, or other risk factors: [⁶] [⁷]

Imaging Tests: Different imaging tests take pictures of the body’s insides and can single out abnormalities, like a tumor, but cannot confirm whether it’s cancer or not. These include x-rays, CT or PET scans, ultrasounds, etc.
Sample Tests: These tests take a sample of the tumor or the blood to confirm whether the growth or tumor is indeed cancer.
Internal Investigation: These tests physically take a camera inside the body to view the tumor.

Stage 3 Ovarian Cancer Symptoms

Here are the early symptoms of ovarian cancer which can be caused by other cancers as well:[⁵]

Bloating or gas
Pelvic or lower belly pain
Loss of appetite or feeling full quickly
Urinary symptoms such as urgency

The following are the other symptoms of ovarian cancer.[⁵]

Fatigue (extreme tiredness)
Upset stomach
Back pain
Pain during sex
Constipation
Changes in a woman's period, such as heavier bleeding than normal or irregular bleeding
Abdominal (belly) swelling with weight loss

Stage 3 Ovarian Cancer treatment

Stage 3 Ovarian Cancer first-line treatment

The first line of treatment against stage 3 Ovarian Cancer is surgery with or without combination therapy. A skilled specialist in treating ovarian tumors, such as a gynecologist or a gynecologic oncologist. The following surgeries are performed to treat stage 3 ovarian cancer.

Hysterectomy: A hysterectomy is the removal of the uterus from the body and any subsequent tumors originating from it.
Salpingo-oophorectomy: A salpingo-oophorectomy is the removal of one or both ovaries and attached fallopian tubes.

In most cases, both surgeries are performed. In the case of stage 3 ovarian cancer, the surgeon checks nearby tissues to analyze the degree of metastasis.

Surgery is followed by another systemic treatment, such as chemotherapy, to kill and remove the remaining cancer cells.

Other types of treatment for stage 3 Ovarian Cancer

Other treatments for stage 3 ovarian cancer include localized treatments like radiation or systemic treatments like chemotherapy or intraperitonial chemotherapy, hormone therapy, and targeted drug therapy.[⁸]

Radiation Therapy: high-energy x-rays to kill cancer cells.
Chemotherapy: drugs that kill cancer cells taken via IV injections or through a catheter in the peritoneal cavity.
Hormone Therapy: Hormones and hormone-blocking drugs to defeat cancer.
Targeted Drug Therapy: Drugs that kill the parts of cancer cells that separate them from normal cells.

While treating stage 3, Ovarian cancer Surgery is often combined with one or more of these other types of treatment. Since the cancer cells have migrated to other parts of the body, such as the lymph nodes or peritoneum, the surgical removal of reproductive organs is not enough to treat the disease. Doctors may suggest the best option from among these however, intraperitonial chemotherapy is the most often paired treatment.

Can stage 3 Ovarian Cancer be cured?

Through treatment involving surgery and chemotherapy, even advaced stage 3 ovarian cancer can be cured. Although once the cancer has reached stage three, it is likely no longer curable through surgery alone, more than half cases are diagnosed at this stage. If the cancer is uncurable, the goal is to kill the cancer cells and leave the body cancer free for as long as possible. [⁹]

Prognosis: Stage 3 Ovarian Cancer Survival Rate

Stage 3 Ovarian Cancer survival rate

According to the American joint commission on cancer, the survival rate for stage three ovarain cancer after 5 years is 41%. [¹⁰] Ovarian cancer’s survivability is higher than that of lung, liver, brain, or pancreatic cancer. However, it has the lowest survivability in cancers, exclusive to women. [¹¹] Compared to the 41% five-year survival rate of stage 3 ovarian cancer, the average five-year survival rate for all cancers in all stages is 67%. [¹²]

Stage 3 Ovarian Cancer Recurrence Rate

When ovarian cancer returns after a patient has been cancer free for a certain period, it’s called a recurrence. On average, 70% of all ovarian cancer patients will experience a recurrance post cancer remission or no proof of symptoms.

The risk of recurrence is directly related to the stage at which the cancer was diagnosed. The stage of ovarian cancer tells us how far the cancer has spread.

Once the cancer has spread beyond the pelvic region to the lymph nodes or peritoneum and reaches stage 3, there is a chance it will not be completely wiped out through treatment.

Any remaining cancer cells can localize somewhere else in the body or in the same region, and new cancerous growth can occur.

Patients who were diagnosed at stage 3 have a 70% to 90% chance of experiencing a recurrence. The approach to treating cancer once it’s recurred depends on several factors, including:

Previously attempted treatments
Side effects of previous treatments
Progression of recurred cancer
Number of recurrences
Time since last treatment, or progression-free interval [¹³]

Depending on these factors, more or less aggressive treatments can be explored. Continual communication with the doctor is necessary to weigh treatment, side effects, quality of life, and the patient’s expectations.

In some cases, a less aggressive treatment with minimal impact on the quality of life that keeps cancer at bay may be chosen over an intense, aggressive treatment that causes unbearable side effects but may cure the disease.

Stage 3 Ovarian Cancer growth rate

The growth rate of ovarian cancer gets higher the farther it spreads. Therefore the growth rate of stage 1 is much slower than the growth rate of stage 3 ovarian cancer. It is estimated that ovarian cancer originating in the fallopian tubes takes around 6.5 years to reach one or both ovaries. Once it has spread further, the growth rate increases significantly when cancer cells begin to migrate to other tissues.

Ovarian cancer’s growth rate also depends on the type of cells it originates from. There are low-grade and high-grade epithelial ovarian cancers. Low-grade malignancies grow slower than high-grade malignancies. [¹⁴]

Lifestyle Changes for Preventing and Managing Ovarian Cancer

There is no sure-fire way of preventing ovarian cancer. There are some known risk factors that you can work on to reduce the chances of getting ovarian cancer. However, that would only reduce the risk and not eliminate it entirely. The following will reduce your risk of developing ovarian cancer:

Taking hormonal birth control for over five months continuously
Bearing and giving birth to a child
breastfeeding, especially for over a year or more
Tubal ligation, hysterectomy, or any part of the reproductive system removed

Ultimately, the best method of combating ovarian cancer the early discovery of the illness. If you have any of the known risk factors like a family history of ovarian or breast cancer, test positive for certain genes, have irregular periods, or are overweight, you should get regularly pelvic exams and imaging to check for any suspicious cell growth.

Conclusion

Takeaway

Stage 3 ovarian cancer is when the tumor has spread from beyond the ovaries and fallopian tubes to nearby tissues such as the lymph nodes and the peritoneum. More than half of cases of ovarian cancer are diagnosed at this stage because early symptoms are not distinct.

For stage 3 ovarian cancer, surgery combined with chemotherapy is the most chosen route of treatment, sometimes intraperitoneal chemotherapy. Radiology, hormone therapy, and targeted drug therapy are also considered.

People diagnosed with stage 3 face a 70% to 90% chance of recurrence, and their 5-year survival rate is 41% compared to the average of 67% across all cancers. Childbearing, breastfeeding, taking birth control, and avoiding hormonal therapy post-menopause reduce your risk of developing ovarian cancer.