How Long Do You Have to Live With Stage IV Ovarian Cancer?

The following data gives us the approximate survival statistics of women diagnosed with different types of ovarian cancer:

• Epithelial ovarian cancer: The 5-year relative survival rate for patients diagnosed with stage IV cancer is 31%. Epithelial ovarian tumors develop from the cells that cover the outer surface of the ovary. If epithelial ovarian cancer is diagnosed and treated before the cancer has spread outside the ovary, the prognosis is good. Many cases of more advanced cancer may respond well to treatment, but cancer often comes back (recurs) and further treatment is needed.
• Ovarian stromal tumors: The 5-year relative survival rate for patients diagnosed with ovarian stromal tumors at stage IV is 60%. Ovarian stromal tumors are a rare class of tumors that develop from connective tissue cells that hold the ovary together and cells that produce the female hormones, estrogen and progesterone.
• Ovarian germ cell tumors: The 5-year relative survival rate for patients diagnosed at stage IV is 73%. Ovarian germ cell tumors develop from the cells that produce the ova or eggs. Most germ cell tumors are benign (noncancerous), although some are cancerous and may be life-threatening. These can usually be treated successfully, although there may be a small risk of cancer recurrence and further treatment is needed.
• Fallopian tube carcinoma: The 5-year relative survival rate for patients diagnosed with fallopian tube carcinoma at stage IV is 45%.

In stage IV ovarian cancer, the cancer has spread from the ovaries to more distant organs. The subtypes of this stage are:

• Stage IVA: This is when the cancer has spread to the sheets of tissue (called pleura) that line the lungs. There is no spread to other organs, such as the liver, spleen, intestine or lymph nodes outside the abdomen. Stage IVA is usually diagnosed when cancer cells cause fluid to build up between the two sheets of tissue.
• Stage IVB: This is when the cancer has spread to organs or lymph nodes outside the abdomen, which may include the liver or spleen.

Stage IV ovarian cancer is graded in addition to being staged, to show how active it is and how quickly or slowly it grows. Stage IV cancers may be graded if they are treated with surgery. The grades are as follows:

• Grade I (sometimes also called well-differentiated cancer): When seen under a microscope, the cancerous cells are well-differentiated from normal cells. They look darker, with a prominent cell nucleus.
• Grade II (moderately differentiated): Cells in this grade look more abnormal and are expected to grow slightly faster. They have abnormal cell membranes.
• Grade III (poorly differentiated): Cells in this grade cannot be differentiated into individual cells and are most aggressive.

Surgery is usually considered the best treatment for stage IV ovarian cancers. Women who have more advanced cancers will often have debulking surgeries. Common treatment options are:

• Debulking surgery: The surgeon will attempt to remove as much mass as possible. Data collected in many studies has demonstrated that the more cancer that is removed, the better the long-term outcome for the patient. Sometimes, the cancer will recur after debulking surgery, in which case it may be useful to debulk the tumor a second time, particularly if a year has passed between the initial surgery and the recurrence.
• Palliative treatment: In patients with very advanced stage IV ovarian cancer, surgery may be used for palliation. This means the surgery is done to ease pain or symptoms, not to eliminate the disease.
• Chemotherapy: Some people can be treated for stage IV ovarian cancer with chemotherapy following abdominal surgery. Patients may be recommended to undergo chemotherapy before surgery to shrink the cancer, followed by another course of chemotherapy after the operation. When surgery is not an option, chemotherapy alone may be used to reduce the tumors and control the cancer spread.

Ovarian cancer grows quickly and can progress from early stages to advanced within a year. In the most common form of ovarian cancer, malignant epithelial carcinoma, cancer cells can grow out of control quickly and spread within weeks or months. It is therefore critical to pay attention to symptoms, as this may help improve chances of being diagnosed early and treated promptly. 

Detecting cancer while it is still in the early stages will improve the prognosis. Unfortunately, however, 80% of ovarian cancer patients are not diagnosed until the disease has spread throughout their abdominal cavity. Although the 5-year survival rate for ovarian cancer has improved significantly in the past 30 years, the prognosis for ovarian cancer remains poor overall.