Stage 3 ovarian cancer
The stage of a cancer tells you how big it is and if it has spread. The tests and scans you have to diagnose your cancer will give some information about the stage. But your doctor might not be able to tell you the exact stage until you have surgery.
Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system to stage cancers in the:
- ovaries
- fallopian tubes
- peritoneum
There are four stages, numbered 1 to 4.
Stage 3 ovarian cancer has spread outside the 
into the abdominal cavity or to lymph nodes. Treatment includes surgery and chemotherapy.
What is stage 3 ovarian cancer?
Stage 3 ovarian cancer is in lining of your abdominal cavity (peritoneum). Or it might have spread to the in the back of your tummy (abdomen).
There are three groups - 3A, 3B and 3C:
Stage 3A has 2 groups:
- Stage 3A1 means the cancer has spread to the lymph nodes in the back of your abdomen (retroperitoneal lymph nodes). This is split into 2:
- 3A1(i) means the cancer in the lymph nodes is smaller than 1cm
- 3A1(ii) means the cancer in the lymph nodes is larger than 1cm
- Stage 3A2 means that there are cancer cells in the peritoneum. It might also be in your lymph nodes
Stage 3B means there are cancer growths in the peritoneum that are 2cm or smaller. There might also be cancer in the retroperitoneal lymph nodes.
Stage 3C means there are cancer growths in the peritoneum larger than 2cm. There might also be cancer in your lymph nodes or on the surface of your spleen or liver.
Treating stage 3 ovarian cancer
Treatments for stage 3 ovarian cancer include:
- surgery
- chemotherapy
targeted cancer drugs
Your healthcare team consider several factors when deciding what treatment you need. These include;
- where the cancer has spread to
- whether the specialist surgeon (gynaecological oncologist) thinks they can remove all the cancer
- your general health
Surgery
Your specialist surgeon (gynaecological oncologist) will remove:
- both ovaries
- fallopian tubes
- your womb (including the cervix)
They will also check where the cancer has spread to in your pelvis and if it is in your lymph nodes. Your gynaecological oncologist will aim to remove as much of the cancer as possible.
This is called cytoreductive surgery. You may also hear it called debulking surgery.
Chemotherapy
You might have:
- chemotherapy after surgery – this is called adjuvant chemotherapy with cytoreductive surgery
- chemotherapy before and after surgery – this is called neoadjuvant chemotherapy with interval cytoreductive surgery
- chemotherapy into your abdomen during surgery – this is called hyperthermic intraperitoneal chemotherapy or HIPEC
Your healthcare team will discuss the best treatment for you. When you have chemotherapy will depend on your individual case.
Targeted cancer drug treatment
Some people may have treatment with a targeted cancer drug. This will depend on your situation. You might have a targeted cancer drug:
- with chemotherapy
- on its own after chemotherapy
If surgery isn't possible
It might not be possible to have surgery if your cancer has spread widely or you are not well enough.
You can have chemotherapy on its own to shrink the cancer as much as possible and to slow it down.
You might have other treatments to help relieve your symptoms. This could be treatment for fluid in the abdomen (ascites) or for a blocked bowel. Or radiotherapy to relieve symptoms like pain.
