Is it Ovarian Cancer and if so, what type have I got?
Staging and grading in depth
The Stage
Staging is based on a 1-4 staging system, called the FIGO system after its authors.
Stage 1
This is where the cancer is confined to one or both ovaries and has not yet spread to other areas. It is divided into three sub-sections:
Stage 1a: The cancer is contained inside one ovary, no ascites no tumour on external surface, the surface of the ovary is intact.
Stage 1b: The cancer is contained inside both ovaries, no ascites, no tumour on external surface, the surface of the ovary is intact.
Stage 1c: 1a or 1b AND one or more of the following: (i) there is some cancer on the surface of at least one ovary; (ii) cancer cells are found in fluid (ascites) taken from inside the abdomen during surgery; (iii) the ovary ruptures (bursts) before or during surgery.
Stage 2
This means that the cancer can be found outside of the ovary or ovaries, but has spread no further than the pelvic region (uterus, , bladder, lower intestine). Again there are three sub-sections.
Stage 2a: The cancer has spread into the fallopian tubes or the womb or both
Stage 2b: The cancer has grown into other tissues in the pelvis, for example the bladder or rectum
Stage 2c:2a or 2b AND one or more of the following: (i) there is some cancer on the surface of at least one ovary (ii) cancer cells are found in ascites taken from inside your abdomen during surgery (iii) the tumour bursts before or during surgery
Stage 3
Stage 3 ovarian cancer involves one or both ovaries and has spread beyond the pelvis into the abdominal cavity (but not the liver) and/or to nearby lymph nodes (those in the groin, behind the womb or the upper abdomen). The three sub-sections are:
Stage 3a:Tumour found in one or both ovaries and the pelvic region but cancer can be seen under the microscope in tissue taken from the lining of the abdomen; lymph nodes are negative for cancer
Stage 3b: Tumour found in one or both ovaries and there are confirmed small tumour growths (less than 2 cm in diameter) on the lining of the abdomen; lymph nodes are negative for cancer
tage 3c: Tumour found in one or both ovaries and there are tumour growths larger than 2cm on the lining of the abdomen and/or the lymph nodes contain cancer
Stage 4
Stage 4 indicates that cancer cells have spread to other parts of the body such as the liver, lungs and brain.
The grade
This is done by removing a piece of the suspect tissue and looking at it carefully under a microscope. This indicates how much like or unlike normal tissue the tumour resembles. The term used is differentiation with the well differentiated tumours looking more normal than poorly differentiated.
Grade 0: tumours of low malignant potential, also known as borderline tumours, are the most well-differentiated, and least aggressive.
Grade 1: low grade well-differentiated tumours
Grade 2: moderately differentiated
Grade 3: poorly differentiated, ie least normal, generally the most aggressive