Ovarian Cancer Health Center

After ovarian germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread within the ovary or to other parts of the body.

The process used to find out whether cancer has spread within the ovary or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Certain tests are used in the staging process.

Many of the tests used to diagnose ovariangerm cell tumor are also used to determine the stage of the disease. Unless a doctor is sure the cancer has spread from the ovaries to other parts of the body, surgery is required to determine the stage of cancer in an operation called a laparotomy. The doctor must cut into the abdomen and carefully look at all the organs to see if they contain cancer. The doctor will cut out small pieces of tissue and look at them under a microscope to see whether they contain cancer. The doctor may also wash the abdominal cavity with fluid and then look at the fluid under a microscope to see if it contains cancer cells. Usually the doctor will remove the cancer and other organs that contain cancer during the laparotomy.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

• Through tissue. Cancer invades the surrounding normal tissue.
• Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
• Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

The following stages are used for ovarian germ cell tumors:

Stage I

In stage I, cancer is found in one or both of the ovaries and has not spread. Stage I is divided into stage IA, stage IB, and stage IC.

• Stage IA: Cancer is found in a single ovary.
• Stage IB: Cancer is found in both ovaries.
• Stage IC: Cancer is found in one or both ovaries and one of the following is true:
  • cancer is found on the outside surface of one or both ovaries; or
  • the capsule (outer covering) of the tumor has ruptured (broken open); or
  • cancer cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity).