Within stage I, there are several sub-stages:
IA: One ovary has cancer inside it (but not on its outer surface).
IB: Both ovaries have cancer inside.
IC: One or both ovaries have cancer inside, plus any of these situations:
- IC1: The casing around your tumor came open during surgery. This means cancer cells could get into your abdomen and pelvis.
- IC2: The casing around your tumor came open before surgery, possibly allowing cancer cells to escape. Or, there's cancer on the outside of one or both ovaries.
- IC3: There are cancer cells in fluid in your abdomen. Or your doctor finds them in a saltwater mixture they use to check for cancer cells in that area.
A Look at Survival Rates
Because doctors found your cancer early, the 5-year relative survival rates for stage I are high. A 5-year relative survival rate measures how likely it is that people with a certain type of cancer will be alive 5 years after their diagnosis, compared to people without that cancer.
These numbers can’t tell you how long you will live, because everyone's situation is different. But you can use them to better understand possible outcomes.
The overall 5-year survival rate doesn't factor in what stage your cancer is. Instead, it uses three categories that describe how much your cancer has spread -- localized, regional, and distant. Stage I best fits into the "localized" category, meaning the cancer was found only in your ovary or ovaries. Here are the 5-year relative survival rates for the three main types of ovarian cancers, when they're localized:
- Invasive epithelial ovarian cancer: 92% (This means that people with this cancer are about 92% as likely as people who don't have it to live for at least 5 years after their diagnosis.)
- Ovarian germ cell tumors: 98%
- Ovarian stromal tumors: 98%
Usually, the first treatment for stage I ovarian cancer is surgery to remove the tumor. But the sub-stage and type of tumor you have guide your doctor’s choices about which surgery, and how to treat you afterward.
Three main kinds of cells make up your ovaries. Each one can develop into a different tumor:
- Epithelial tumors, the most common type, come from the cells surrounding the outside of the ovaries.
- Germ cell tumors come from the cells that make your eggs.
- Stromal tumors develop from the tissue cells that make female hormones and keep your ovaries intact.
Invasive Epithelial Ovarian Cancer
When you have this type of cancer, your doctor will most likely take out the tumor through a pair of surgeries called a hysterectomy (removal of your uterus) with bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes).
Your doctor might also take out nearby tissue and your lymph nodes to study. This tells them more about what stage your cancer is in. And they may remove fatty tissue on top of organs called the peritoneum, like your stomach, in your abdomen. This is called an omentectomy.
If you have stage IA or IB, what happens after surgery depends on how abnormal your tumor cells look under a microscope. This is your tumor grade. A lower number often means your chances of recovery are higher.
This is how doctors treat stage IA and IB cancers after surgery:
Grade 1: You usually don’t need more treatment. If you want to have children later, your doctor may take out only your one cancerous ovary and the fallopian tube on that side during surgery. This is called a unilateral salpingo-oophorectomy.
Grade 2: Your doctor keeps a careful eye on you, or you get several rounds of chemotherapy.
Grade 3: You often get chemotherapy.
For stage IC, you'll probably get chemotherapy after your cancer surgery.
Ovarian Germ Cell Tumors
You can have various kinds of tumors with this type of cancer. Which type you have determines what treatment you'll get.
If you have dysgerminoma, the most common type, your doctor will most likely do surgery to remove one ovary and fallopian tube (unilateral salpingo-oophorectomy.) Your treatment may also include:
- An X-ray of your lymph system (lymphangiography) or a CT scan to see whether the cancer has spread
- Close monitoring by your doctor
- Radiation therapy
If you have a different kind of germ cell tumor, you'll probably also have a unilateral salpingo-oophorectomy. Then, your doctor will monitor you closely or you'll get chemotherapy with a combination of anticancer drugs.
Ovarian Stromal Tumors
With this type, your doctor does surgery to take out the ovary that has a tumor. Afterward, they check on you often. But you usually don’t need more treatment.
If you have a type of tumor with a high risk of returning, you may get chemotherapy.