Symptoms
• Ovarian cancer is "the silent killer." Early symptoms are often vague and ignored, leading to late diagnosis after metastasis has occurred. The more common symptoms include1:
o Lower abdominal discomfort or pain
o Abdominal bloating
o Early satiety
o Dyspepsia
o Urinary frequency or incontinence
• Other symptoms that may occur but could be symptoms of other conditions are:
o Change in bowel habits
o Weight loss
o Vaginal bleeding
Staging
• Staging designations were developed by The Federation Internationale de Gynecologie et d'Obstetrique and the American Joint Committee on Cancer.2
o Stage I: Limited to the ovaries
Stage IA: Tumor limited to one ovary; capsule intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings
Stage IB: Tumor limited to both ovaries; capsules intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings
Stage IC: Tumor limited to one or both ovaries with any of the following: capsule ruptured, tumor on ovarian surface, malignant cells in ascites or peritoneal washings
o Stage II: Tumor on one or both ovaries with pelvic extension or implants
Stage IIA: Extension or implants on the uterus or fallopian tubes; no malignant cells in ascites or peritoneal washings
Stage IIB: Extension or implants on other pelvic tissues; no malignant cells in ascites or peritoneal washings
Stage IIC: Pelvic extension or implants (stage IIA or stage IIB) with malignant cells in ascites or peritoneal washings
o Stage III: Tumor on both ovaries with microscopically confirmed peritoneal implants outside the pelvis (superficial liver metastasis equals stage III); tumor limited to the true pelvis but with histologically verified malignant extension to small bowel or omentum
o Stage IIIA: Microscopic peritoneal metastasis beyond pelvis (no macroscopic tumor)
o Stage IIIB: Macroscopic peritoneal metastasis beyond pelvis 2 cm or less in greatest dimension
o Stage IIIC: Peritoneal metastasis beyond pelvis more than 2 cm in greatest dimension or regional lymph node metastasis
o Stage IV: Tumor involving one or both ovaries with distant metastasis (If pleural effusion is present, a positive cytologic test indicates stage IV. Parenchymal liver metastasis equals stage IV.)