Stage IA and IB: Surgery is the preferred choice, and if lab analysis indicates the cancer is Grade 1 or 2, then surgery may be all that is needed. The surgery can include a hysterectomy (removal of the uterus), removal of both fallopian tubes, removal of both ovaries and removal of the lining of the upper part of the abdominal cavity, called the omentum.

Stage IC: Treatment for Stage IA and IB cancers that are Grade 3 is the same as for Stage IC. This consists of surgery as the main therapy plus chemotherapy.

The overall five-year survival rate for Stage IA is greater than 90 percent, and for Stage I it is 80 to 90 percent.

Stage II: Ovarian cancer is not normally diagnosed at this stage, but in such cases, Stage IIA, IIB and IIC are all treated the same, with surgery as described for stage I and combination chemotherapy.

The five-year survival rates for Stages IIA, IIB and IIC are 75, 50 and 40 percent, respectively.

Stage III and IV: The options are the same for both stages. Surgery is the same as for Stage II, and consists of removal of the uterus, both fallopian tubes, both ovaries and the omentum. Surgeons will also "debulk" the tumors, which means reduce them in size as much as possible. The smaller the tumor, the better the patient's outlook. Combination chemotherapy is used after surgery.

The five-year survival rates for Stage III and IV are 15 to 50 percent.

Follow-up
After surgery, and during and after subsequent treatment with chemotherapy, CA-125 blood tests will be performed along with imaging tests to see how well the treatment is progressing and to tell if the cancer has returned. Though it is not a part of standard care, some doctors may want to perform "second-look" surgery to gauge the success of treatment.

Chemotherapy
Chemotherapy involves the use of anti-cancer drugs, taken orally or intravenously. These drugs destroy cancer cells by interfering with their growth or by preventing them from reproducing.

For epithelial ovarian cancer, a combination of drugs is normally used. A platinum compound, such as carboplatin or cisplatin, combined with paclitaxel is considered standard. These drugs are usually given in three- to four-week cycles. In the event of tumor recurrence, platinum agents may be re-initiated. Additional chemotherapy drugs include paclitaxel, topotecan, liposomal doxorubicin, gemcitabine, oral etoposide docetaxel and tamoxifen.

Unfortunately, chemotherapy also harms healthy cells, causing side effects. Cisplatin, for instance, can cause nausea and kidney and neurological damage. Paclitaxel, meanwhile, can cause bone-marrow suppression, fatigue, allergic symptoms, hair loss and diarrhea, among other symptoms. Some of these side effects can be treated with other drugs - anti-nausea medications, for example, for nausea.