Stage 4 Ovarian Cancer

Before discussing about stage IV ovarian cancer, let's get a brief idea about what is an ovarian cancer. Ovarian cancer occurs in women especially after the age of 45, in the form of tumors that develop in one or both ovaries. In most of the cases, it arises from the outer lining of the ovary called epithelium and sometimes from the egg cells (germ cell tumor). Ovaries are a pair of small organs that are part of the female reproductive system. They release ova or eggs and also produce essential hormones like estrogen and progesterone. Ovarian cancer is malignant, i.e. it can spread to other tissues and organs. Due to a process called metastasis, these tumors intrude the neighboring organs or lymph nodes, or may enter the bloodstream and spread to other body organs. It is difficult to diagnose ovarian cancer as the observable symptoms occur quite late in the disease. Initially, the symptoms are not noticeable until the tumors grow and apply pressure to other organs in the abdomen. This leads to diagnostic delays, resulting in a late stage 4 ovarian cancer and poor prognosis. But some of the late symptoms of the disease include menstrual irregularity, pelvic pain or pressure, abdominal swelling or bloating, abnormal pubertal development, urinary frequency, ascites, diarrhea and nausea.

Staging Ovarian Cancer

Staging of a cancer helps the doctor to know how far the disease has spread. For staging, samples of tissues are taken from different parts of the pelvis and abdomen and examined under intense observation. The staging should be accurate as the prognosis and treatment of the cancer is often decided according to the stage. There are four stages in ovarian cancer:

• Stage 1: The ovarian cancer is only in the ovaries.
• Stage 2: The cancer spreads outside the ovaries and enters the pelvis.
• Stage 3: The cancer spreads outside the pelvis into the abdominal cavity, and is also detected in the lymph nodes in the upper abdomen, groin or behind the womb.
• Stage 4: Stage 4 is the final stage of the ovarian cancer. The patients during this stage display parenchymal liver metastases and extra-abdominal metastases. Liver and lungs are the most common areas where the cancer spreads. The spleen may also get affected, and some patients exhibit metastases of the brain.

Treatment for Stage 4 Ovarian Cancer

When the patient reaches Stage IV, which is the most advanced and dangerous stage, the treatment begins with a surgery that includes hysterectomy (surgical uterus removal) and chemotherapy. Though it is difficult to eradicate the cancer completely, both optimal cytoreductive surgery and platinum-based chemotherapy prolong the time to cancer recurrence and improve overall survival. In cytoreductive surgery, the physicians try to remove most of the ovarian cancer from the patient's body by reducing the number of cancer cells. Clinical studies have shown that the patients who had optimal cytoreductive surgery prolong the duration of survival and prevent more recurrences of cancer. Chemotherapy is usually performed after the surgery and consists of paclitaxel and a platinum compound administered every 3 weeks for 6 - 8 cycles. The treatment is considered to be best for patients who have reached the advanced stage of ovarian cancer.

Though the purpose of treatment for stage 4 ovarian cancer is to increase the patient's chances of cure and survival, there are variety of factors that influence a patient's decision regarding the treatment for ovarian cancer. Along with the treatment, the key factor for surviving ovarian cancer is to have a positive, upbeat attitude towards the situation.