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Stage 1 Ovarian Cancer Explained

Medically reviewed by Howard Goodman, M.D.
Written by Maureen McNulty
Posted on June 17, 2021

Ovarian cancer develops when cells in the ovary begin growing out of control. These cancerous cells multiply, forming a tumor, and may eventually spread to other parts of the body. Ovarian cancer also includes cancer that starts in the fallopian tubes (the organs that carry egg cells from the ovaries to the uterus) and the peritoneum (the tissue that lines the abdomen).

About 15 percent of people with ovarian cancer have stage 1 disease at the time of diagnosis. A stage 1 diagnosis means that ovarian cancer has been detected early, before it has spread outside of the ovaries.

What Is Stage 1 Ovarian Cancer?

Doctors assign a stage when giving an ovarian cancer diagnosis. The stage of cancer tells you how far it has spread. It also helps your doctor plan treatments and estimate your outlook. Doctors use two systems for ovarian cancer staging. The International Federation of Gynecology and Obstetrics (FIGO) system and the American Joint Committee on Cancer (AJCC) system both determine how serious your cancer is and how best to treat it.

Stage 1 ovarian cancer exists in one or both ovaries or fallopian tubes. Cancer cells have not spread to distant organs or tissues. People with this cancer stage do not have cancer cells in nearby lymph nodes (glands that remove germs and waste).

Three substages make up stage 1 ovarian cancer. In stage 1A (stage IA), cancer is in only one ovary or fallopian tube and is only found on the inside of the organ. In stage 1B (stage IB), cancer cells are in the insides of both ovaries or both fallopian tubes. A person is diagnosed with stage 1C (stage IC) if one or more of the following is true:

  • Stage IC1 — The tumor broke open during surgery, which could lead to cancer cells spreading around the abdomen.
  • Stage IC2 — The tumor broke open before surgery, or cancer cells are growing on the outer surface of the ovaries or fallopian tubes.
  • Stage IC3 — There are cancer cells in the abdominal or pelvic fluid.

There are several types of ovarian cancer, with the main groups being epithelial, germ cell, and stromal cancer. When epithelial ovarian cancer is diagnosed at stage 1, it is most likely to be the clear cell, endometrioid, or mucinous subtypes. Germ cell tumors and ovarian stromal cell cancers are also likely to be diagnosed at an early stage.

Read more about the types of ovarian cancer.

Stage 1 Ovarian Cancer Treatments

Doctors often treat people who have stage 1 ovarian cancer with surgery and chemotherapy. The exact treatment that a person receives depends on their age, overall health, cancer stage, type of cancer, and cancer grade (how quickly the cells are growing). People with stage 1 fallopian tube or peritoneal cancer receive the same treatments as people with stage 1 ovarian cancer.

Surgery

Doctors use surgery to remove early-stage tumors. Surgery also helps doctors stage the cancer. Although imaging tests before surgery also provide staging information, doctors can more easily see how far cancer has spread when performing surgery.

The exact surgical procedure that doctors use depends on where the cancer is located. Doctors may perform one or more procedures to treat stage 1 ovarian cancer:

  • Oophorectomy — Removal of the ovaries
  • Salpingectomy — Removal of the fallopian tubes (when combined with removal of the ovaries, the procedure is called a salpingo-oophorectomy)
  • Hysterectomy — Removal of the uterus
  • Omentectomy — Removal of the omentum (fat that covers certain abdominal organs)
  • Biopsy — Taking a small sample from the lymph nodes or other organs to see if the cells are cancerous

You can no longer have children if you have your uterus or both ovaries or fallopian tubes removed. However, if you have certain types or stages of ovarian cancer, you may be able to keep some of these organs. Stage 1A epithelial ovarian cancer only grows in one ovary or fallopian tube. The cancerous organs need to be removed, but doctors might be able to leave the other ovary and fallopian tube if you still want to have children in the future. Additionally, germ cell and stromal tumors often grow in just one ovary, and doctors may be able to leave the other ovary.

Additional treatments for stage 1 ovarian cancer depend on the cancer grade. For people with low-grade (grade 1) stage IA or IB disease, surgery may be the only treatment needed.

Chemotherapy

People with epithelial ovarian cancer may need chemotherapy if they have high-grade (grade 2 or 3) stage 1A or stage 1B disease. People with stage 1C epithelial ovarian cancer also usually undergo chemotherapy. Chemotherapy drugs usually include Paraplatin (carboplatin) or Platinol (cisplatin) and Taxol (paclitaxel) or Taxotere (docetaxel).

People with stage 1 germ cell tumors may also receive chemotherapy. In some cases, doctors may recommend a watch-and-wait approach, in which a person has regular doctor’s visits and tests. In this case, a person will only receive additional treatment if the cancer comes back. Chemotherapy drugs often include a combination of Platinol (cisplatin), VP-16 (etoposide), and Blenoxane (bleomycin).

Stage 1 stromal tumors usually aren’t treated with chemotherapy. However, doctors may recommend chemotherapy for high-risk tumors that have an increased chance of coming back, including those that are very large, ruptured (broken apart), or high-grade.

Outlook for Stage 1 Ovarian Cancer

A person’s outlook after being diagnosed with ovarian cancer depends on several factors. Doctors consider a person’s age, overall health, cancer stage, and ovarian cancer subtype when estimating their outcome.

Researchers measure survival rates for ovarian cancer using a five-year overall survival rate. This number says how likely a person with a particular cancer is to live for five years or more, compared to people without that disease. The five-year relative survival rate for those with stage 1 ovarian cancer varies based on the type of ovarian cancer:

  • Epithelial ovarian cancer — 93 percent
  • Stromal tumors — 98 percent
  • Germ cell tumors — 98 percent
  • Fallopian tube cancer — 95 percent

These numbers are calculated based on people who were diagnosed five to 10 years ago. Because treatments are constantly improving, people who are diagnosed today may have a better outlook than those who were diagnosed a decade ago. In new guidelines, the American Society of Clinical Oncology recommends offering genetic testing for BRCA1, BRCA2, and other ovarian cancer susceptibility genes to those diagnosed with epithelial ovarian cancer.

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. Members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

Are you living with stage 1 ovarian cancer? Share your experiences in the comments below, or start a conversation by posting on MyOvarianCancerTeam.

Posted on June 17, 2021
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Howard Goodman, M.D. is certified by the American Board of Obstetrics and Gynecology and specializes in the surgical management of women with gynecologic cancer. Review provided by VeriMed Healthcare Network.. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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