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Ovarian cancer is not one single disease — it’s a type of gynecologic cancer (cancer of the female reproductive system). Cancers that fall under this umbrella include tumors that grow in the ovaries, fallopian tubes, and peritoneum (tissue that lines the inside of your abdomen).
Some ovarian cancers are caught early when the tumor is still small. Others are more advanced, meaning the tumors have grown larger or spread to other organs. Advanced ovarian cancer is usually harder to treat and has a worse outlook.
If you’re diagnosed with ovarian cancer, your doctor will perform tests to find out your cancer’s stage. Often, the exact stage can’t be confirmed until after surgery. Your stage describes whether the cancer has spread and how large it is.
Doctors stage ovarian cancer in different ways. One common method uses Roman numerals between I and IV. Stage I (stage 1) ovarian cancer is considered early-stage cancer. Cancers at this stage are only located in the ovary or fallopian tube.
Stage IV (stage 4) cancer is the most advanced. In this case, cancer cells have spread to other organs, such as the liver, bone, brain, or lungs. When a tumor has spread outside of the ovaries (stages 2-4), it’s considered advanced-stage cancer.
Many people have advanced ovarian cancer by the time they’re diagnosed. For others, what began as early-stage cancer may progress to late-stage cancer over time or return after successful treatment. When ovarian cancer comes back after remission, it is called recurrent ovarian cancer.
Studies estimate that about 20,890 people in the United States will be diagnosed with ovarian cancer in 2025. About 80 percent of people with ovarian cancer have advanced cancer by the time they’re diagnosed.
Ovarian cancer can cause symptoms at any stage, but most people won’t have any symptoms until the cancer reaches advanced stages. Common symptoms include:
Read more about managing advanced ovarian cancer symptoms.
Early detection of ovarian cancer is important. It’s essential to get regular checkups and talk to your doctor about any new symptoms you experience. People with a family history of ovarian or breast cancer or who have mutations in the BRCA1 and BRCA2 genes or other related genes may be at high risk for developing this disease.
If you have these risk factors, your doctor may recommend regular screening tests to check for signs of cancer. Some people with BRCA1 and/or BRCA2 mutation may also choose preventive surgery to remove the ovaries and fallopian tubes, especially if they don’t plan to have more children. You can discuss this treatment option with your doctor.
If your doctor wants to screen you for ovarian cancer or suspects you may have it, they may recommend blood tests or imaging tests. Blood tests can check for proteins, such as cancer antigen 125 (CA-125), which are produced by cancer cells. Imaging tests, including ultrasounds, CT scans, or MRI scans, can help your doctor see what your ovaries look like.
Your outcome depends on the type of ovarian cancer you have. The five-year relative survival rates show the likelihood of someone living with this cancer type for at least five years compared to someone without it.
These survival rates include both early and advanced stages of cancer. They are general estimates based on large numbers of people and don’t necessarily predict what will happen in your case. Other factors, like how advanced your cancer is, your age, or any other health problems you may have, can affect your outcome. Talk to your oncology care team for a better idea of what you should expect from ovarian cancer.
Treatment for advanced ovarian cancer can have different goals. These goals may include:
The treatment you choose may depend on factors like:
Surgery is often used to treat advanced ovarian cancer. During surgery, doctors aim to remove as much cancer as possible. This may involve removing your ovaries, fallopian tubes, and uterus. If your cancer is very advanced, you may not be able to have surgery.
Chemotherapy is often used to treat advanced ovarian cancer both before and after surgery. These medications can kill cancer cells that have spread throughout the body. Platinum-based therapies are often used for advanced ovarian cancer, usually in combination with other chemotherapy drugs. For example, your oncology provider might recommend using carboplatin (Paraplatin) or cisplatin (Platinol), along with paclitaxel or docetaxel.
Other drugs may be used with or without chemotherapy to treat advanced ovarian cancer. The drugs recommended will depend on how well you’ve responded to platinum-based chemotherapy and other treatments in the past.
For example, targeted therapies are medications that can specifically recognize and destroy cancer cells. Types of targeted therapy for ovarian cancer include:
The type recommended will depend on the specific type of ovarian cancer you have. Talk to your oncologist if you’d like to know more about these types of drugs.
Clinical trials may be an option for people with advanced ovarian cancer, especially for those who have already had several treatments. If you join a trial, you’ll have access to new treatments that aren’t yet part of standard cancer care. Talk to your doctor to learn more about taking part in cancer research.
Other treatments are less common for advanced ovarian cancer but may be used in some cases. These include:
A diagnosis of advanced ovarian cancer can feel overwhelming. You may have to make a lot of decisions, rethink your future plans, and adjust your daily routine. However, you don’t have to figure it all out alone. There are many resources that can help.
Advanced cancer often causes many symptoms and side effects. Palliative care focuses on relieving symptoms, easing pain, and helping you feel more comfortable. You can receive palliative care while also receiving other treatments aimed at curing your cancer. A palliative care team can help you understand your treatment options and provide emotional support. Talk to your doctor if you’re interested in learning more about palliative care.
Sometimes, the best treatment option is none at all. This might be a temporary decision. For example, if you have advanced cancer but no symptoms, your doctor may recommend delaying treatment until your symptoms worsen. This can help you avoid side effects from treatment.
You may also decide to stop all cancer treatments permanently because you feel the risks outweigh the benefits. In some cases, treatment may not be expected to help much. Most treatments come with side effects that can affect your physical and mental health. It’s important to have open conversations with your doctor about what’s realistic to expect from each treatment option. They can also refer you to specialists who can help you manage anxiety and stress while living with advanced ovarian cancer.
If you decide to stop cancer treatments, you can choose to receive hospice care. Hospice is end-of-life care that connects you with a care team that helps manage your physical, mental, emotional, and spiritual needs. With hospice care, you can still receive medical care to reduce pain and improve your quality of life, but you won’t receive treatments like chemotherapy. You can receive hospice care at a hospital, nursing home, or in your own home.
If you have advanced cancer, you may reach a point where you become too sick to make your own medical decisions, such as whether to have cardiopulmonary resuscitation (CPR) or use a ventilator. Advance care planning helps you think about and make these decisions ahead of time.
Start by talking to your doctor about the types of decisions you may face in the future related to your cancer care. These decisions are usually recorded in a legal document called an advance directive. In the United States, the two most common types of advance directives are a living will and durable power of attorney for healthcare. You don’t need a lawyer for this process, though it can be helpful. Your doctor can explain how the process works in your area.
Many hospitals or care centers also have social workers or other professionals who can guide you through these decisions and help you talk with your loved ones.
In addition to planning for your future medical care, you may also need to plan for certain practical matters. Many people with cancer struggle financially when paying for cancer treatments. A social worker can help you find local services and organizations that support people with cancer.
Another thing you may want to consider is creating a will. This document explains what will happen to your assets and belongings once you die. Lawyers can help you write a will, or your care team may know local services that can help.
On MyOvarianCancerTeam, the social network for people with ovarian cancer and their loved ones, more than 7,000 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.
Have you been diagnosed with advanced ovarian cancer? Share your experiences in the comments below, or start a conversation by posting on your Activities page.
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