Ovarian Cancer
Recognize the stage of ovarian cancer (ovaries)
When you diagnose
ovarian cancer, your oncologist will try to find out if the cancer cells have
spread or not. If it has spread, the doctor will find out how far it extends.
That way, your doctor can consider the right ovarian cancer treatment for you.
The stage of
ovarian cancer has 4 locations or levels. The lower the story, the fewer cancer
cells that spread. Conversely, when the group is high, it means that cancer
cells have spread to many places.
According to the American Cancer
Society website, Figo system (International Federation
of Gynecology and Obstetrics) and AJCC (American Joint Committee on Cancer) use
classification in determining the stage of cancer, including:
- T(tumor) indicates the
size of cancer.
- Signs of N (lymph nodes) that indicate the spread of cancer
cells to nearby lymph nodes
- Sign M (metastatic) is the spread of cancer cells to
areas of the bone, liver, or lungs
More clearly, the
division of the stage of ovarian cancer (ovaries) includes:
1. Stadium 1/I
Stage 1 ovarian
cancer indicates that cancer only exists in the ovaries. At this rate, ovarian
cancer is further divided into several groups, namely:
Stage I
(T1-N0-M0): The cancer is
present only in the ovaries or fallopian tubes and has not spread.
Stage IA
(T1A-N0-M0): only one ovary
is affected by cancer; the tumor is only on the inside of the ovary. No cancer
was detected on the surface of the ovary, and no malignant cancer cells were
detected in the abdominal or pelvic area.
Stage IB
(T1B-N0-M0): both ovaries
are affected by cancer, but no cancer has been detected on the surface of the
ovaries, abdomen, or pelvis.
Stage IC
(T1C-N0-M0): cancer is
present in one or two ovaries, followed by the following information:
- stage IC1 (T1C1-N0-M0) of the ovarian
tissue surrounding the tumor is not intact or ruptured during surgery;
- stage IC2 (T1C2-N0-M0) of the ovarian
tissue surrounding the tumor ruptures before surgery, and there are
abnormal cells on the outer surface of the ovary; and
- Stage IC3 (T1C3-N0-M0) cancer cells
are detected in the abdomen or pelvis.
At this level, a
common treatment is the surgical removal of the tumor. In some cases, the
uterus, both fallopian tubes, or both ovaries are removed. This surgery is
known as hysterectomy with bilateral salpingo-oophorectomy.
2. Stadium 2/II
Stage 2 ovarian
cancer means cancer has grown outside the ovary or grown in the area around the
pelvis. At this rate, ovarian cancer is further divided into several groups,
namely:
Stage II
(T2-N0-M0): Cancer is
present in one or both ovaries and has spread to the pelvis, for example, the
uterus or bladder.
Stage IIA
(T2A-N0-M0): Cancer has
spread to the uterus (uterus) and/or to the fallopian tubes.
Stage IIB
(T2B-N0-M0): Cancer
affects other organs in your pelves, such as the bladder or anus.
Treatment for
this stage of cancer is hysterectomy with bilateral salpingo-oophorectomy.
Then, continue with chemotherapy after surgery for at least 6 cycles.
3. Stadium 3/III
Stage 3 ovarian
cancer indicates cancer has spread beyond the pelvic area, into the abdominal
cavity, or into the lymph nodes behind the abdomen. At this rate, ovarian
cancer is further divided into several groups, namely:
Stage 3A
(T1/2-N1-M0 or T3A-N0/N1-M0): The cancer is present in either ovaries or fallopian tubes. During surgery,
no tumor is visible outside the pelvis inside the naked eye. Still, small cancer
deposits are detected in the lining of the abdomen (peritoneum) or in the
peritoneal folds (omentum) under a microscope. Cancer may or may not spread to
nearby lymph nodes.
Stage 3B or
IIIB (T3B-N0/N1-M0):
Tumors less than 2 cm in diameter are visible outside the pelvis inside the
abdomen. The surrounding lymph nodes may or may not contain cancer cells.
Stage 3C or
IIIC (T3C-N0/N1-M0): Tumors
more than 2 cm in diameter are detected outside the pelvis inside the abdomen
and possibly outside the liver or spleen.
In this stage of
cancer, the treatment is not much different from stage 2 cancer. It's just that
the choice of drugs and the cycle of chemotherapy that is done maybe more.
4. Stadium 4
Stage 4 ovarian
cancer indicates that cancer has spread to other body organs, such as the liver
and lungs. At this rate, ovarian cancer may also cause
complications. Ovarian
cancer in stage 4 is further divided into several groups, namely:
Stage IVA
(T-any N-M1A): Cancer
cells are found in the fluid around the lungs.
Stage IVB
(T-any N-M1B): Cancer has
spread to the inside of the spleen, liver, distant lymph nodes, or other organs
such as the lungs and bones.
In addition to
the stage, also recognize the term grade for ovarian cancer.
The term
"grade," which doctors use in diagnosing and treating ovarian cancer
patients, is useful for helping predict how cancer cells spread and how quickly
cancer cells grow. In this type of ovarian cancer, the grade is divided into:
- Grade 1 (well-differentiated) cancers have cells
that are very similar to normal cells and are less likely to spread or
recur.
- Grade 2 (somewhat differentiated) and grade 3 (less
differentiated) cancers showed an increase in appearance abnormalities
compared to normal cells. Cancer cells of this grade also tend to spread
and recur.
Cell
differentiation refers to the process by which cells specialize in performing a
task or choosing a place in the body.
Can stage 4 ovarian cancer be cured?
In stage 4 (IV)
cancer, cancer has spread far from where the cancer cells originated. At this
rate, cancer is very difficult to cure, but it can still be treated. The
treatment of ovarian cancer is done not to fix but to help relieve the symptoms
of ovarian cancer to make the patient's life better.
Stage 4 ovarian
cancer cannot be cured and treated in the same way as stage 3 cancer.
Initially, the doctor will perform surgery to remove the tumor and remove the
cancer cells. Then, the doctor will also ask the patient to undergo
chemotherapy and possibly targeted therapy.
Another option in
treating stage 4 ovarian cancer is to undergo chemotherapy first. This is done to
shrink the size of the tumor; surgery can be done and resumed with
chemotherapy.
On average,
chemotherapy is done as many as 3 cycles before surgery and 3 more cycles after
surgery. The latter treatment option is combined with palliative care.
