Ovarian Cancer Staging

What Methodologies are used to correctly “Stage” Ovarian Cancer?

When doctors find cancer, they want to “stage” the cancer in order to find out just how widespread the cancer is. Most ovarian cancers which are not obviously widespread, are staged during surgery. In order to stage the tissue, samples are taken from various parts of the pelvis and abdomen, and examined under a microscope. Staging is extremely important, since your treatment will be based on the stage of your cancer, and the doctor will determine your prognosis based on the staging.

Inaccurate staging could result in any cancer which has spread outside the ovaries being missed, therefore not treated. Once your ovarian cancer is given a stage, it will not change, even if the cancer recurs or spreads to a new location. Staging allows you to make informed decisions regarding your ovarian cancer treatment. Ovarian and fallopian tube cancer are generally staged via the FIGO system which relies on the results of surgery to determine the extent of the main tumor—using the letter “T.”

The letter “N” describes the absence or presence of metastasis to nearby lymph nodes. The absence or presence of distance metastasis are described by the letter “M.” This information is all combined to make a determination on the final stage of the ovarian cancer. Once your T, N, and M categories are determined, this information is combined with a process known as stage grouping. The stages are as follows:

• Stage I ovarian cancer is only within the ovary, ovaries or fallopian tubes, and has not spread.
  • Stage IA—Cancer is in one ovary and the tumor is confined to the inside of the ovary—no cancer on the outer surface of the ovary or on the abdomen or pelvis.
  • Stage IB—Cancer is in both ovaries but not on the outer surface or the abdomen or pelvis.
  • Stage IC—Cancer is in one or both ovaries and one or more of the following has occurred: 1) the tissue surrounding the tumor broke during surgery which could potentially allow cancerous cells to leak into the abdomen and pelvis—Stage IC1, 2) Cancer is present on the outer surface of at least one of the ovaries—Stage IC2, 3) Laboratory found cancer cells in fluid from abdomen—Stage IC3
• Stage II ovarian cancer is in one or both ovaries and has spread to other organs within the pelvis, however has not spread to lymph nodes or more distant sites.
  • Stage IIA—Cancer which started in the ovaries has spread to the fallopian tubes or uterus, or vice- versa.
  • Stage IIB—The ovarian cancer has grown into nearby pelvic organs such as the rectum, colon or bladder.
• Stage III ovarian cancer is in one or both ovaries and has spread beyond the pelvis to the lining of the abdomen, or to the abdominal lymph nodes.
  • Stage IIIA1—Ovarian cancer is in both ovaries and may have spread into nearby pelvic organs
    • Stage IIIA1(i)—ovarian cancer has spread in the lymph nodes to 10 mm or smaller, or
    • Stage IIIA1(ii)—ovarian cancer has spread in the lymph nodes to more than 10 mm.
  • Stage IIA2—Ovarian cancer is in one or both ovaries and may have spread into nearby pelvic organs. Surgeon was unable to see cancer in the abdomen during the surgery, however under a microscope tiny deposits of cancer are found in the upper abdominal lining.
  • Stage IIIB—Ovarian cancer in one or both ovaries which has spread to pelvic organs. There are deposits of cancer large enough for the surgeon to see in the abdomen, and the cancer may have spread to the liver or spleen.
  • Stage IIIC—Ovarian cancer in one or both ovaries which has spread to pelvic organs, Deposits of ovarian cancer in the abdomen, on the outside of the liver or spleen, and possibly to the lymph nodes.
• Stage IV ovarian cancer is the most advanced stage; at this stage the ovarian cancer has spread to the inside of the spleen, lungs or liver.
  • Stage IVA—Ovarian cancer cells are also found in the fluid surrounding the lungs.
  • Stage IVB—Ovarian cancer has spread to the inside of the spleen or liver, to lymph nodes and/or to other organs such as the lungs, brain and skin.

The Baby Powder with Talc Problem: Talcum Powder Ovarian Cancer Lawsuits

Recent J & J talcum powder ovarian cancer lawsuits have brought the issues of talcum powder cancer to the forefront. Johnson & Johnson continues to maintain that its products with talc are perfectly safe, however three juries have found otherwise.

1. The first Johnson & Johnson talcum powder lawsuit was held in 2013. The jury found in favor of Deane Berg, a woman from South Dakota who developed ovarian cancer after years of using J & J baby powder with talc. In a curious move, although the jury agreed J & J was negligent in their failure to warn about the potential risks of using talcum powder in the genital region, they awarded Berg no damages.
2. The second J & J trial was held in February 2016, brought by the family of Jacqueline Fox, who died about four months before the trial began from ovarian cancer. A Missouri jury found in favor of the plaintiff, awarding the Fox family $72 million–$10 million in compensatory damages, and $62 million in punitive damages. In a deposition read to the jury, Jacqueline Fox stated she had used J & J baby powder with talc and Shower to Shower for more than three decades.
3. The third trial, also before a Missouri jury, resulted in a $55 million settlement for Gloria Ristesund, who developed ovarian cancer in 2011, after using J & J baby powder with talc and Shower to Shower for feminine hygiene, for nearly four decades.

Is Talcum Powder Ovarian Cancer Classified Differently?

Women with a history of using Talcum Powder for feminine hygiene may wonder if talcum powder ovarian cancer is Staged any differently than Ovarian Cancer in general. The answer very simply is “No”. While the origination or cause of specific ovarian cancers may differ, the Staging system, which classifies the localization and/or degree of spread of a cancer, is the same for all Ovarian Cancers. Talcum Powder Ovarian Cancer describes an ovarian cancer the pathology of which may have been given rise to by the presence of talc fibers embedded in the ovaries. Talcum Powder related Ovarian Cancer may be more likely to manifest as an epithelial tumor type, but again, the Staging system is the same as the one outlined above.

Special Considerations about Your Ovarian Cancer Diagnosis: Talcum Powder, Baby Powder with Talc, and Shower to Shower

Receiving a diagnosis of ovarian cancer can be very frightening. If you are a victim of ovarian cancer, and you used talcum powder (contained in baby powder with talc and in “Shower to Shower”) for feminine hygiene, it could be very beneficial to speak with a knowledgeable talcum powder ovarian cancer attorney. You may be entitled to compensation for your injuries, including medical expenses and lost wages. A well-qualified and knowledgeable Baby Powder Ovarian Cancer Attorney may also be able to pursue potential damages on your behalf for pain and suffering.