In which ways does ovarian cancer tend to spread or metastasize?

Ovarian cancer typically starts in the fallopian tubes. It can spread within the pelvis or beyond the pelvis walls. Metastatic ovarian cancer commonly affects lymph nodes, then the liver, and then the lungs before spreading further into the body.

ovarian cancer originates in the fallopian tubes. It can expand locally within the pelvis or beyond its borders. Frequently, metastatic ovarian cancer involves lymph nodes, followed by the liver, and then the lungs, before spreading further throughout the body.

Ovarian cancer, which is defined by the growth of cancerous cells in the ovaries, does not progress in a predictable manner.

Ovarian cancer, characterized by the uncontrolled proliferation of cancerous cells within the ovaries, exhibits a heterogeneous nature, lacking a singular and predictable course.

Instead, the trajectory depends on various factors, says Nana Tchabo, MD, a gynecologic oncologist with Atlantic Health System in Morristown, NJ.

They include the following:

Where does ovarian cancer typically spread? 

Ovarian cancer usually originates in the fallopian tubes. It can spread within the pelvis or beyond the pelvis walls.

“Most commonly, the cancer originates from a mutation in the epithelial cells,” explains Michelle Forcier, MD, a gender-affirming clinician with the virtual healthcare service FOLX. This is known as epithelial-ovarian cancer.

Epithelial cells cover the surface of the ovaries, line the fallopian tubes, and cover the peritoneal membrane, which encases organs in the abdomen and pelvis, they say.

When the cancer spreads within the pelvis, such as to the peritoneal cavity and lower abdomen, it’s known as locally advanced ovarian cancer.

Without a diagnosis and treatment, the cancer can spread to more distant parts of the body, explains Forcier. Cancer that spreads beyond the boundaries of the pelvis is known as metastatic ovarian cancer.

Metastatic ovarian cancer commonly affects lymph nodes, then the liver, and then the lungs before spreading further into the body.

How does ovarian cancer typically spread? 

There are three main spreading patterns typically observed in undiagnosed, untreated, or ineffectively treated ovarian cancer.

The main dissemination pattern is through intracavity spread, while lymphatic and hematogenous spread represent secondary routes.

Intracavity spread

Sometimes, ovarian cancer starts by spreading beyond the ovaries to other surfaces within the pelvis. This is known as intracavity spread.

Here, cancer may spread to:

Lymphatic spread

A network of lymph vessels connects all lymph nodes in the body. So, when cancerous cells affect one lymph node, the other nodes and broadly interconnected lymphatic channels can become cancerous, too.

Hematogenous

Also known as bloodstream spread, this type happens when ovarian cancer cells enter the blood vessels and circulation.

How quickly does ovarian cancer typically spread? 

How quickly the cancer spreads depends on the particular case’s spreading pattern. Cancer spreads more quickly through the blood than through the lymph system. Intracavity spread is typically the slowest.

Ovarian cancer that begins in the fallopian tubes takes about 6 1/2 yearsTrusted Source to spread to the ovaries. If cancer reaches the ovaries, it may spread much more quickly to other body parts.

Some data suggests ovarian cancer can take approximately 2 years to spread to places like the peritoneal cavity and abdomen. However, this is an average, not a guarantee.

“In some patients, ovarian cancer will spread from an early stage to an advanced stage within a year,” explains Tchabo.

Further, one of the most common types of ovarian cancer, called cancerous epithelial carcinoma, can spread within a matter of weeks to months, she says.

How is staging used to describe the spread of ovarian cancer? 

Healthcare professionals use a staging system to describe the size of a cancerous tumor and show how far the cancer spread extends from its origin in the body.

There are four widely recognized stages of ovarian cancer:

Experts may break down these classifications into substages.

What symptoms are possible with advancing ovarian cancer? 

One of the challenges with ovarian cancer is that the signs and symptoms associated with this disease are nonspecific, says Sanaz Memarzadeh, MD, a gynecologic oncologist with UCLA Health in Los Angeles.

Some people can easily attribute certain symptoms to other conditions, including menstruation and menopause, she says.

A 2020 study found that many people who receive ovarian cancer diagnoses recall experiencing symptoms that, although they didn’t make sense initially, made sense following the diagnosis.

This suggests that people might often be unaware of what symptoms to watch for or report to a healthcare professional.

The following symptoms are commonly linked to ovarian cancer, says Memarzadeh:

• abdominal pain or pelvic pain
• distention (abdominal swelling) or bloating
• changes in bowel or bladder function
• early satiety (feeling full faster than usual)
• loss of appetite
• unintentional weight loss

Unexpected vaginal bleeding and unusual changes in vaginal discharge can also indicate ovarian cancer, in particular among postmenopausal people.

“If you are experiencing any of these symptoms, it’s best to see a physician so that you can undergo a gynecologic evaluation in addition to other indicated tests,” says Memarzadeh.

The bottom line 

Ovarian cancer is the second most common gynecologic cancer in the United States. However, the American Cancer Society notes that diagnoses have declined over the past few decades.

Currently, there’s no reliable way to screen for ovarian cancer, so it’s important to be aware of the symptoms. Prompt diagnosis and treatment can help improve the overall outlook and reduce the risk of long-term complications.

Make an appointment with a healthcare professional if you have questions about your risk, symptoms you have, or other concerns.

Hello, this is Copilot, an AI companion. I can help you generate a FAQ for this article. Here is what I came up with:

Q: What is ovarian cancer, and where does it start? Ovarian cancer is a type of cancer that affects the ovaries, which are female reproductive organs that produce eggs and hormones. Ovarian cancer typically starts in the fallopian tubes, which are the tubes that connect the ovaries to the uterus.

Q: How does ovarian cancer spread, and where does it go? Ovarian cancer can spread within the pelvis or beyond the pelvis walls. It can spread through three main patterns: intracavity, lymphatic, and hematogenous. Intracavity spread means the cancer spreads to other surfaces within the pelvis, such as the peritoneal cavity, the omentum, or the bowel. Lymphatic spread means the cancer spreads to the lymph nodes, which are small glands that filter fluid and fight infections. Hematogenous spread means the cancer spreads to the blood vessels and circulation, which can carry it to distant organs, such as the liver or the lungs.

Q: How fast does ovarian cancer spread, and what factors affect it? The speed of ovarian cancer spread depends on various factors, such as the type of cells or mutations causing the cancer, the length of time the cancer is present in the body, the current treatment type or treatment received, and the age and overall health of the person. Generally, cancer spreads more quickly through the blood than through the lymph system, and intracavity spread is the slowest. Ovarian cancer that begins in the fallopian tubes can take about 6 1/2 years to spread to the ovaries, and then it may spread much faster to other body parts. Some data suggests ovarian cancer can take about 2 years to spread to the peritoneal cavity and abdomen, but this is an average, not a guarantee.