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Stage 2 Ovarian Cancer Explained

Posted on June 22, 2021
Medically reviewed by
Howard Goodman, M.D.
Article written by
Maureen McNulty

Stage 2 ovarian cancer begins in the ovaries. It also includes cancers that develop from the fallopian tubes (tubes that connect the ovaries and the uterus) or the peritoneum (the lining of the abdomen). About 1 out of 5 people with ovarian cancer have stage 2 disease when they are diagnosed. Stage 2 ovarian cancer has spread to nearby tissues outside of the ovaries but still in the pelvis (but not to more distant parts of the body). Doctors often treat this type of cancer with a combination of surgery and chemotherapy.

What Is Stage 2 Ovarian Cancer?

When giving an ovarian cancer diagnosis, doctors also assign a stage. The stage is based on how far cancer has spread and describes how serious each case of ovarian cancer is. Doctors use staging information to recommend treatments and estimate outlook. The stages of ovarian cancer are based on two similar staging systems: the International Federation of Gynecology and Obstetrics (FIGO) system and the American Joint Committee on Cancer (AJCC) system. The stage is sometimes written using Roman numerals. For example, stage 2 may also be written as stage II.

People with stage 2 ovarian cancer have cancer in one or both ovaries, or one or both fallopian tubes. They do not have cancer in nearby lymph nodes (glands that fight infection) and do not have metastases (tumors in distant organs). Stage 2 ovarian cancer has spread to nearby tissues. There are two substages:

  • Stage 2A (stage IIA) — Cancer is growing from the ovary into the fallopian tube or uterus.
  • Stage 2B (stage IIB) — Cancer has spread to nearby organs like the intestines, bladder, or rectum.

Stage 2 Ovarian Cancer Treatments

Several factors influence which treatments you receive. Your treatment options are based on whether you are healthy enough to have surgery or chemotherapy, which locations your cancer has spread to, and whether the surgeon can remove all of your cancer. In some cases, the goal of treatment is to cure cancer — remove all cancer cells from the body and prevent it from returning. In other cases, cancer can’t be cured, and doctors use treatments to try to keep cancer from growing and spreading for as long as possible.

Treatments may be different between the three main types of ovarian cancer: epithelial cancer, stromal cancer, and germ cell tumors.

Surgery

Treatment for stage 2 epithelial ovarian cancer begins with surgery. During surgery, doctors try to remove as much of the cancer as they can in what’s called debulking surgery. In addition to taking out tumors, surgeons may need to take out various tissues or organs that contain cancer cells. There are several possible surgical procedures:

  • 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

When doctors take out the uterus or remove both ovaries or fallopian tubes, a person will no longer be able to have children. In some cases of stage 2 cancer, including in many cases of germ cell and stromal tumors, cancer cells only grow in one ovary or fallopian tube. Doctors may be able to remove only the cancerous ovary and leave the other one in place, allowing a woman to have children in the future.

Chemotherapy

Many people with ovarian cancer receive chemotherapy. Chemotherapy is a medication that kills cancer cells or prevents them from growing and dividing. When chemotherapy is given after initial surgery, it is called adjuvant chemotherapy. Adjuvant chemotherapy helps kill any cancer cells that were left behind after surgery and helps prevent cancer from coming back. In some cases, people have chemotherapy before or instead of surgery. This chemotherapy may be a good option for those who aren’t healthy enough to undergo surgery or who have a tumor that can’t be fully removed. Having chemotherapy before surgery can sometimes make it easier for doctors to remove cancer.

The most common chemotherapy drugs used to treat epithelial ovarian cancer are Paraplatin (carboplatin) and Taxol (paclitaxel). These chemotherapy drugs are usually given intravenously (through a tube that transports medicine into a vein).

Chemotherapy may also help people with stage 2 germ cell tumors or ovarian stromal cancer. One common treatment plan is BEP, a combination of three chemotherapy drugs. BEP includes Blenoxane (bleomycin), Veoesid (etoposide), and Platinol (cisplatin). Doctors may also give hormone therapy, such as the drugs tamoxifen or anastrozole, to people with stage 2 stromal cancer.

Stage 2 Ovarian Cancer Outlook

Researchers measure survival rates based on how far cancer has spread. Stage 2 ovarian tumors are regional, which means they have spread to nearby tissues or lymph nodes but not to more distant locations. A person’s outlook also varies based on what type of ovarian cancer they have:

  • People with epithelial ovarian cancer are about 75 percent as likely to live for five years or more, compared with people who don’t have ovarian cancer.
  • People with ovarian stromal tumors are 89 percent as likely to live for five years or more.
  • People with germ cell tumors are 94 percent as likely to live for five years or more.
  • People with fallopian tube cancer are 53 percent as likely to live for five years or more.

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. If ovarian cancer runs in your family, genetic testing may help you learn whether you are at increased risk.

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, 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 2 ovarian cancer? Share your experiences in the comments below, or start a conversation by posting on MyOvarianCancerTeam.

All updates must be accompanied by text or a picture.
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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