Select a condition Absence seizures Acne ADHD Age-related macular degeneration AIDS Alzheimer's disease AMD Amebic dysentery Anal tears Angina, stable Angina, unstable Ankle sprain Anorexia Anxiety Appendicitis Arthritis Asthma in adults Asthma in children Athlete's foot Atrial fibrillation Attention deficit hyperactivity disorder (ADHD) Autism Back pain Bacterial vaginosis Bad breath Bedsores Bedwetting Bell's palsy Benign prostatic hyperplasia Bipolar disorder Bladder infection in women Blood pressure Breast cancer Breast pain Bronchiectasis Bronchiolitis Bronchitis Bulimia Bunions Burning mouth syndrome Burns and scalds Canker sores Cardiac arrest Carpal tunnel syndrome Cataracts Cellulitis and erysipelas Chickenpox Childbirth, heavy bleeding Childbirth, tear or cut Chlamydia Chronic bronchitis Chronic fatigue syndrome Chronic obstructive pulmonary disease Chronic prostatitis Chronic tension type headache Cold sores Colic in babies Colon and rectal cancer Colon and rectal cancer screening Colonic diverticular disease Common cold Conjunctivitis Constipation in adults Constipation in children COPD Crib death Deep vein thrombosis Dementia Depression in adults Depression in children Diabetes, type 1 Diabetes, type 2 Diarrhea in adults Diarrhea in children Diverticular disease Ear infection, middle ear Ear infection, outer ear Ear infection with discharge Ear infection with fluid Ear pain during air travel Ear wax Eczema Emphysema Endometriosis Enlarged prostate Epilepsy Episiotomy Erection problems Essential tremor Febrile seizures Fertility problems Fibroids Flu Gallstones Genital herpes Genital warts GERD GERD in children Glaucoma Gonorrhea Gout Group B streptococcus H. pylori infection Halitosis Hay fever Headache, chronic tension type Head lice Heart and circulation problems in diabetes Heart attack Heartburn Heart failure Heavy periods Heel pain Hemorrhoids Hepatitis B Hepatitis C Hernia Herpes, genital Herpes simplex eye infection High blood pressure High blood pressure in pregnancy High cholesterol HIV infection Hyperactivity IBS Incontinence in women Infection in newborn babies Infertility Influenza Insomnia in adults Irritable bowel syndrome Jaundice in newborn babies Jet lag Kidney infection Kidney stones Leg cramps Leg ulcers Lewy body dementia Lung cancer Lyme disease Macular degeneration Malaria prevention Manic depression Mastalgia Measles, mumps and rubella: prevention Melanoma Meniere's disease Meningococcal disease Menopause Migraine in adults Migraine in children MMR prevention Morning sickness Multiple sclerosis Nail infection, fungal Neck pain Nicotine addiction Non-Hodgkin's lymphoma Nosebleeds in children Obesity Obsessive-compulsive disorder OCD Oral thrush Osteoarthritis Osteoporosis Ovarian cancer Painful periods Pancreas cancer Panic attacks Parkinson's disease PCOS Pelvic inflammatory disease Perineal care Peripheral arterial disease Peripheral vascular disease Pneumonia Polycystic ovary syndrome Postpartum depression Postpartum hemorrhage Post-traumatic stress disorder Preeclampsia Pregnancy, nausea Premature birth Pressure sores Prostate cancer Prostatitis, chronic Psoriasis PTSD Raynaud's disease Rectal cancer screening Recurrent cystitis Reflux in children Rheumatoid arthritis Scabies Schizophrenia Seasonal allergy Shoulder pain Sickle cell anemia Sickle cell disease SIDS Sinusitis Skin cancer (melanoma) Skin cancer (squamous cell) Sleep apnea Sleep problems in children Slipped disk Smoking Sore throat Stomach ulcers Stress headache Stress incontinence Stroke, emergency care Stroke prevention Sudden infant death syndrome Swimmer's ear Tennis elbow Tension headache Testicular cancer Thrush (oral) Tic douloureux Tinnitus Tonsillitis Toxoplasmosis in pregnancy Trigeminal neuralgia Underactive thyroid Urinary tract infections in children Varicocele Varicose veins Vascular dementia Warts Whiplash Wisdom teeth, impacted Wrinkles Yeast infection, vagina

Select treatment area Bladder & Kidneys Blood Brain & nervous system Cancer Children's health Diabetes Digestive system Ear, nose & throat Eating & weight Eyes Fertility Heart and circulation Hormones Infections Lungs & breathing Men's health Mental health Mouth Muscles & bones Pregnancy & childbirth Sexual health Skin Sleep Staying healthy Travel health Women's health

If you have ovarian cancer, it's very important to find out how far it has spread. This is called the stage of your cancer. It will help you and your doctor decide what treatment is best. And it can help tell how long you're likely to live and your chances of being cured.

During your operation to check your ovaries for cancer, your surgeon will:

• Look for cancer everywhere in your pelvis and abdomen
• Send some fluid or washings from your abdomen to the laboratory to check for cancer cells under the microscope (washings are fluid that the surgeon has flushed through your abdomen)
• Send some small bits of tissue (called biopsies) to the laboratory to check for cancer cells under the microscope.

To learn more, see Surgery to check for ovarian cancer.

You may also have some or all of these tests to see how far your cancer has spread.

• A chest X-ray to check your lungs.
• Blood tests to see if your kidneys and liver are working properly. If they aren't, it could mean that the cancer is blocking the flow of urine from your kidneys or there is cancer in your liver.
• A CT scan or an MRI scan, which gives good pictures of the inside of your body.
• A special X-ray of your kidneys and bladder that uses a dye that you swallow. This helps show anything unusual in these organs.
• A barium enema test to see if there are any ovarian cancer cells in your colon. With this test, a liquid that contains the chemical barium is put into your rectum. The barium sticks to the lining of your colon. This helps your doctor see if there are any abnormal spots on your X-ray.

The results of surgery and these tests will help your doctor stage your cancer.^{1 2}

Doctors split ovarian cancer into four main stages, from stage 1 (the earliest) to stage 4 (the most advanced). The lower the stage of your cancer, the longer you're likely to live and the better your chances of being cured. For more information, see What will happen to me?

Here's what the stages mean.

In stage 1, you have cancer in one or both of your ovaries, but it hasn't spread anywhere. Stage 1 is split into three categories.

Stage 1A: You have cancer in only one of your ovaries.

Stage 1B: You have cancer in both of your ovaries.

Stage 1C: You have cancer in one or both of your ovaries and any one or more of the following apply to you:

• You have cancer on the surface of one or both ovaries
• Your cancer has broken through the wall of an ovary
• You have cancer cells in fluid or washings from your abdomen.

In stage 2, you have cancer in one or both of your ovaries, and it has spread to other areas of your pelvis. Stage 2 is split into three categories.

Stage 2A: Your cancer has spread to your womb, your fallopian tubes or both.

Stage 2B: Your cancer has spread to other tissues in your pelvis.

Stage 2C: Your cancer has spread to your womb or fallopian tubes or other tissues in your pelvis and and one or more of the following apply to you:

• You have cancer on the surface of one or both of your ovaries
• Your cancer has broken through the wall of an ovary
• You have cancer cells in fluid or washings from your abdomen.

In stage 3, you have cancer in one or both of your ovaries, and it has spread to other parts of your abdomen. It may also have spread to the surface of your liver. Stage 3 is split into three categories.

Stage 3A: Your cancer is only in your pelvis, but it has spread to the lining of your abdomen (the peritoneum). Your surgeon can't see the cancer, but it shows up under the microscope.

Stage 3B: Your cancer has spread to the lining of your abdomen, but is less than 1 inch across. Your surgeon can see it.

Stage 3C: Either one or both of these things have happened:

• Your cancer has spread to the lining of your abdomen and is more than 1 inch across
• Your cancer has spread to the lymph nodes in your abdomen.

In stage 4, your cancer is in one or both of your ovaries, and it has spread beyond your abdomen to other parts of your body. It may be in your liver, your lungs or both.

Unfortunately, the disease is diagnosed in most women after it has spread outside the ovary. In only about 1 in 4 women, the cancer is still at an early stage (stage 1) when it's found.³

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.