Stage 4 Ovarian Cancer: Meaning, Treatment & Survival Rates

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If you or a loved one has recently been diagnosed with Stage 4 ovarian cancer, there’s a lot of information to take in. Living with any chronic illness can feel overwhelming, but there’s plenty to consider when coping with a cancer that has spread.

The statistics can seem scary, and you might have questions about survival rates and what to expect. Read on to learn more about what stage 4 ovarian cancer means, available treatment options, and how to understand the numbers.

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chronic or terminal illness?

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one living with a
chronic or terminal illness?

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of Companies
is here to help.

What Is Stage 4 Ovarian Cancer?

Stage 4 ovarian cancer is ovarian cancer that has spread to other areas of the body, such as the lungs or liver. It’s classified as metastatic, or the most advanced form of cancer. Stage 4 ovarian cancer is further divided into Stage 4a and Stage 4b, based on where the cancer has spread to.

Stage 4a Ovarian Cancer

Stage 4a ovarian cancer is when the cancer cells have spread to the lungs or the fluid around the lungs, In stage 4a, the cancer has not spread to other areas, such as the spleen, liver, or the lymph nodes beyond the abdomen.

Stage 4b Ovarian Cancer

Stage 4b ovarian cancer is when the cancer cells have spread to the spleen, liver, or the lymph nodes beyond the abdomen.

What Is Ovarian Cancer?

Ovarian cancer is a disease in which abnormal cells in or near the ovaries grow out of control. Abnormal growth can also start in the fallopian tubes or peritoneum (tissue lining the abdominal cavity). Cancer may affect three main types of cells in the ovaries: epithelial, germ, and stromal cells.

  • Epithelial tumors begin in the cells that cover the outer surface of the ovary. The majority of ovarian cancer tumors are epithelial cell tumors.
  • Germ cell tumors start in the cells that produce eggs.
  • Stromal tumors begin in structural tissue cells that produce hormones and hold the ovary together.

There are four stages of ovarian cancer, with each one progressing in severity. 

What to Expect from Stage 4 Ovarian Cancer

Stage 4 ovarian cancer is the most severe form of the illness. Early stage ovarian cancer often doesn’t present with any signs, so early detection can be difficult. Symptoms like pelvic or abdominal pain are often misdiagnosed as other conditions. 

To date, physicians have yet to develop a successful ovarian cancer screening test. Therefore, many women are diagnosed when the cancer is in advanced stages, meaning that it’s spread to other locations in the body.

Where Does Ovarian Cancer Spread To?

Ovarian cancer can spread throughout the body by several means. These include directly through the tissues in the pelvis and abdomen, through the lymph nodes, and through the blood vessels.

If ovarian cancer progresses to stage 4, it may spread to the:

  • Stomach
  • Intestines
  • Chest
  • Lungs
  • Liver 
  • Spleen
  • Brain
  • Skin

Advanced Ovarian Cancer Symptoms

Earlier stages of ovarian cancer typically don’t cause symptoms, but in later stages signs will likely appear. 

Stage 4 ovarian cancer symptoms include:

  • Pain in the pelvis or abdomen
  • Abdominal discomfort or bloating 
  • Vaginal discharge or abnormal bleeding outside of your menstrual cycle or after menopause
  • Changes in bowel patterns, including diarrhea or constipation
  • Frequent urination
  • Feeling full quickly when eating
  • Weight loss
  • Fatigue
  • Back pain

Treatment Options for Stage 4 Ovarian Cancer

Stage 4 ovarian cancer treatment usually involves a combination of interventions, including chemotherapy, surgery, and certain cancer medications.

Surgery

One common way to treat ovarian cancer is by surgically removing the affected organs. During early stages, a doctor may remove one or both ovaries and one or both fallopian tubes. In this case, the uterus remains intact, so it’s still possible to become pregnant with your own natural or frozen eggs, or eggs from a donor.

If your cancer is more extensive, your doctor may recommend surgically removing the ovaries, the fallopian tubes, the uterus, nearby lymph nodes, and a fold of fatty abdominal tissue called the omentum.

When cancer has spread to other parts of the body, your doctor may advise surgery to remove as much of it as possible.

Chemotherapy

Chemotherapy is a class of drugs that use chemicals to target and kill cells that are overgrowing in the body, including cancer cells. A doctor may prescribe these drugs as an oral pill or intravenously through the veins.

Doctors typically prescribe chemotherapy for ovarian cancer after surgery to kill any cancer cells that remain. They sometimes prescribe this treatment before surgery as well.

Chemotherapy can cause a number of difficult side effects. Along with killing cancer cells, the medications can damage other cells in the body. Common side effects include nausea, vomiting, diarrhea, constipation, fatigue, anemia, hair loss, loss of appetite, and infections.

Targeted Cancer Drugs

In targeted cancer therapy, doctors prescribe medications that identify and attack weak points in the cancer cells, thus killing the affected tissue. Before starting targeted cancer treatment for ovarian cancer, your doctor may run some tests to identify which type of targeted drugs will be most effective for you.

Stage 4 Ovarian Cancer Survival Rates

The American Cancer Society categorizes stage 4, ovarian cancer survival rates based on the type of tumor. 

The five-year survival rates for ovarian cancer are:

  • Epithelial ovarian cancer: 31%
  • Ovarian stromal tumors: 70%
  • Germ cell tumors of the ovary: 74%

In other words, 31 out of every 100 people with epithelial ovarian cancer will be alive five years after diagnosis.

However, these numbers aren’t set in stone and survival rates can vary based on many factors, including age, treatment type, and overall health.

Age Matters

According to a research review published in the International Journal of Women’s Health, younger women may have a better chance of surviving ovarian cancer at any stage. This is because younger women can tolerate more aggressive treatments and are more likely to be in better overall health than women over the age of 64.

How Long Can You Live With Ovarian Cancer?

Your survival rate with ovarian cancer depends on many factors, including stage, severity, and treatment type. If it’s caught early in the first stage, up to 93 percent of people with ovarian cancer will still be alive in five years.

Odds change as ovarian cancer worsens, with the five-year survival rate for stage 4 ovarian cancer as low as 31 percent. 

FAQ

Here are answers to frequently asked questions about stage four ovarian cancer.

Is Stage 4 Ovarian Cancer Terminal?

Stage 4 ovarian cancer can be terminal, but it isn’t always. Stage 4 ovarian cancer life expectancy varies from person to person. Depending on the type of tumor, the illness has a five-year survival rate of 31 to 74 percent. 

While it’s very difficult to cure this kind of cancer using currently available treatments, it can still be treated with the goal of helping patients feel better and live longer.

Is Stage 4 Ovarian Cancer Painful?

Stage 4 ovarian cancer is often painful. One of the chief symptoms is pain in the pelvic region, as well as pain, bloating, and discomfort in the abdomen and a frequent need to urinate.

Palliative Care and Hospice Care Options for Stage 4 Ovarian Cancer

If you or a loved one has been diagnosed with stage 4 ovarian cancer, you may want to consider palliative care. This is a specialized form of care that focuses on providing relief from pain and other symptoms, and enhancing quality of life for those living with chronic illnesses.

In addition to medical care, a palliative care team of doctors, nurses, specialists, social workers, dietitians, and spiritual advisors such as chaplains will work with you to cater to your needs.

Treatment Can Continue With Palliative Care

Starting palliative care doesn’t mean doctors stop trying to treat or cure your cancer. You’ll receive treatment to manage your symptoms, and you can still continue treatments meant to stop or cure your illness.

When stage 4 ovarian cancer becomes terminal and treatments have stopped being effective, it might be time to consider hospice care. This type of care focuses on managing symptoms and enhancing comfort at the end of your life.

During hospice care, treatments intended to cure your illness are halted as your care team prepares you and your loved ones to transition out of life. You can receive hospice care at home or at a hospice facility.

For more information, see our article on the 5 Stages of Palliative Care.

Summary

A stage 4 ovarian cancer diagnosis can be overwhelming, but treatment options, including palliative care, are available to help alleviate your symptoms, enhance your quality of life, and help you live longer.

The Sage Family of Companies is here to answer any questions you may have.

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References

Ovarian cancer in the world: epidemiology and risk factors [2019].

Survival Rates for Ovarian Cancer [2023].

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Ashley Welch's Profile Picture
Ashley Welch is a journalist focusing on health and science reporting with more than a decade of experience in both breaking news and long-form storytelling. She served as the health editor for CBSNews.com for several years, reporting, writing, and editing daily health news articles and features. She is currently a freelancer writing for a mix of local, national, and international publications.