Where Does Ovarian Cancer Spread?

Medically Reviewed by Melinda Ratini, MS, DO on July 18, 2022
Written by Alexandra Benisek
4 min read

When ovarian cancer moves beyond your ovaries or fallopian tubes, cancer cells may reach your liver, lungs, or other places in your body. The stage your doctor assigns to your ovarian cancer can tell you how far the disease has spread.

Ovarian cancer cells can spread through your body in these ways:

  • Directly through your pelvis and abdomen
  • Through your lymph nodes, glands that are part of your immune system
  • Through your blood vessels

In addition to your lymph nodes, ovarian cancer cells may move to your:

  • Lungs or the fluid in your lungs
  • Liver
  • Spleen
  • Intestines
  • Brain
  • Skin

Certain lymph nodes are more likely to be affected. These include:

  • Those in your pelvis
  • Para-aortic lymph nodes, found in your abdominal area
  • Mediastinal lymph nodes, in the area between your lungs

Ovarian cancer spreads differently in different people. But if it’s not caught in the earlier stages, it usually follows a similar pattern. It tends to first move to your pelvis, then to further areas of your abdomen and peritoneal cavity (the space that holds your stomach, liver, and intestines), to your lymph nodes, and then to your liver.

But just because ovarian cancer cells have moved into these areas doesn’t mean they’ve formed tumors, or metastasized, yet. Often, doctors can still effectively treat your cancer at this point.

If the cancer isn’t treated successfully, it will keep moving to other parts of your body. Ovarian cancer is a type of cancer that tends to spread. More than 70% of people with this type of cancer already have metastasis when they’re diagnosed.

Some types of ovarian cancer can move from early stages to more advanced within a year. Others develop more slowly.

Experts think that ovarian tumors that begin in your fallopian tubes (as most are thought to) take about 6½ years to spread to your ovaries. But once they get there, they can spread quickly to nearby parts of your body. If not treated effectively, the cancer then spreads to other organs further away.

How fast your ovarian cancer spreads is also based on other things. The grade of your cancer cells – which rates how much they look like healthy cells and can predict how they’ll act – plays a role.

Epithelial ovarian cancers, which account for 90% of all ovarian cancer cases, can be high-grade or low-grade. High-grade cancers, in which the cancer cells look least like healthy cells, are most common. These tend to grow and spread faster. Low-grade cancers are slower to grow and spread.

But high-grade ovarian cancers usually respond better to treatment. Low-grade forms can be resistant to cancer therapies.

You might not have any symptoms during the early stages of ovarian cancer. Many of its symptoms are similar to those of other common, mild conditions. You could notice:

  • Bloating or swelling in your belly area
  • Discomfort in your abdomen
  • You need to pee more often, or more urgently
  • You get full quickly when you eat

But once ovarian cancer spreads, you’re more likely to have symptoms. You might notice things like:

If you’ve already been diagnosed with ovarian cancer and notice these symptoms, tell your doctor. They can check to see whether your cancer has spread.

Doctors use a process called staging to describe how much cancer has spread. They consider which organs the disease has affected and look at how the cancer spread to these places. Staging helps your doctor create the most appropriate treatment plan for you.

The stages go from I to IV, with higher numbers meaning more advanced cancer:

Stage I ovarian cancer. The cancer hasn’t gone beyond your ovaries at this point. This stage includes three sub-groups: stage IA, stage IB, and stage IC. In stage IA, your cancer is in just one of your ovaries or fallopian tubes. In stage IB, it’s spread to both ovaries or fallopian tubes. In stage IC, your cancer has moved beyond your ovaries and fallopian tube. It’s on the outside surface of your ovary or in the space around the ovary, called the peritoneal cavity.

Stage II ovarian cancer. The cancer has spread to nearby areas of your pelvis. Experts divide this stage into two substages. In stage IIA, your cancer has spread to your uterus. In stage IIB, it’s moved to neighboring organs in your abdomen like your bladder or rectum.

Stage III ovarian cancer. The cancer has moved beyond your pelvis. In stage IIIA, it’s spread outside your peritoneal cavity through your lymph nodes. In stage IIIB, your tumor is about 2 centimeters in size and has spread outside your abdominal area. In stage IIIC, your cancer has moved outside your pelvic area and your tumor is larger than 2 centimeters. It may also now affect other organs, like your liver.

Stage IV ovarian cancer. The cancer has spread to distant areas. In stage IVA, it’s moved near your lungs. In stage IVB, the cancer is in the lymph nodes of your groin.