Yes, in many women. In the United States, more than 9 in 10 women whose cancer is only in the ovary are alive 5 years later [1]. But nearly half of ovarian cancers are found after they have spread [1]. Even then, surgery to remove all of the tumour and chemotherapy can get rid of the disease, and about 2 in 10 women with advanced cancer are effectively cured [8, 11]; PARP inhibitor tablets have greatly lengthened the time without disease in women with a BRCA mutation or HRD-positive cancer [9, 10].
Key points
- The earlier, the better the chance of cure: in the United States, more than 9 in 10 women whose cancer is only in the ovary are alive 5 years later [1].
- Nearly half of ovarian cancers are found after they have spread, because the early symptoms are vague and are mistaken for digestive problems [1, 4].
- The type of cancer matters: the most common type (high-grade serous) is aggressive but usually responds well to the first treatment; some other types have a higher chance of survival [2, 4].
- Removing all of the tumour with surgery is the strongest predictor of how long women with advanced ovarian cancer live [8].
- In women with a BRCA mutation who took olaparib tablets after chemotherapy, nearly half were alive 7 years later and had not needed any further treatment [9].
- Fluid in the abdomen (ascites) does not on its own mean stage 4, and if there is a lot of fluid and it is uncomfortable, the doctor can drain it to ease symptoms [5, 12].
Is malignant ovarian cancer curable? What does "cure" mean?
Every cancer is a "malignant" tumour, so "malignant ovarian cancer" simply means ovarian cancer. If you have a cyst or lump on the ovary and do not know whether it is dangerous, read: Ovarian cyst or ovarian cancer: how can you tell? and What is the difference between a benign and a malignant tumour?
A cure means the cancer goes away completely and does not come back. In ovarian cancer, the first treatment is surgery and chemotherapy, and its aim is to destroy every cancer cell; if no cancer cells are left after the first treatment, a cure can be expected [11]. In early cancer this aim is reached most of the time [1]. In advanced cancer, most women go into remission after the first treatment, but in many of them the disease comes back later [4]. Even so, according to one review, about 2 in 10 women with advanced ovarian cancer live for more than 12 years and are effectively cured [11].
Is ovarian cancer deadly? Ovarian cancer is the deadliest cancer of the female reproductive organs, mainly because it is found late [3, 4]. But this does not mean that most women with it die of it: in the United States, about half of all women with ovarian cancer are alive 5 years later [1]. Know the warning signs: What are the symptoms of ovarian cancer?
How curable is ovarian cancer? The chance of survival by stage and type
| Stage | What it means | Out of 10 women |
|---|---|---|
| Only in the ovary | The cancer has not yet spread outside the ovary | More than 9 |
| Spread nearby | It has reached nearby tissue or lymph nodes | About 7 |
| Spread further | It has reached more distant places | About 3 |
| All stages together | Everyone, at any stage | About 5 |
Compared with people of the same age without cancer; for women diagnosed between 2015 and 2021. These numbers are averages, do not fully reflect newer treatments and cannot predict what will happen to one person [1].
| Type | Out of 10 women, how many are alive 5 years later? | Note |
|---|---|---|
| Serous (the most common type) | About 4 | 8 in 10 are found at stage 3 or 4 [2] |
| Endometrioid | About 8 | |
| Mucinous | About 7 | |
| Clear cell | Nearly 7 | |
| Germ cell and sex cord-stromal tumours | At stage 1, almost all | Rare types; mostly found in younger women and at stage 1 [2] |
These numbers count only deaths from the cancer itself, in women diagnosed some years ago. The differences between types are partly because the serous type is usually found later [2]. The type of your cancer is written in your pathology report.
What improves the chance of a cure?
Complete surgery in a specialist centre
Removing all visible tumour is the strongest factor for survival in advanced cancer, whether surgery is done first or after a few cycles of chemotherapy [8]. This surgery should be done by a specialist gynaecological cancer team [3, 7]. Read more: treatment of ovarian cancer by stage.
Complete chemotherapy
The standard treatment for advanced cancer is two drugs, carboplatin and paclitaxel, every 3 weeks for 6 cycles [7]. Most women go into remission with the first treatment [4]. Read more: carboplatin and paclitaxel in ovarian cancer.
BRCA and HRD testing
Every woman with high-grade ovarian cancer (other than the mucinous type) should have a BRCA test at diagnosis; the result of this test and of the HRD test decides which tablet is given after chemotherapy [7]. Read: Is cancer hereditary?
Have PARP inhibitor tablets increased the chance of cure?
After surgery and chemotherapy, women whose tumour has a BRCA mutation or is HRD-positive (meaning the cancer cells are less able to repair their DNA) take tablets from the PARP inhibitor group, which delay the return of the disease [7]. Results of two large studies with long follow-up:
- BRCA mutation, olaparib for up to 2 years: 7 years later, 2 in 3 women were alive. Nearly half of the women were alive and had still not needed any further treatment; more than twice as many as in the comparison group [9].
- HRD-positive, olaparib with bevacizumab: 5 years later, nearly half of the women were free of the disease; more than twice as many as women who had bevacizumab alone. More women were also alive [10].
The researchers of these two studies wrote that this treatment may increase the chance of cure [9, 10]; longer follow-up is needed to be sure. Read more: the role of PARP inhibitors and BRCA testing in ovarian cancer and olaparib.
Stage 4 ovarian cancer: can it be treated, and what is the survival rate?
Stage 4 means the fluid around the lungs contains cancer cells, or the cancer has grown into organs such as the liver or reached places outside the abdomen [5]. Stage 4 can be treated too: with surgery and chemotherapy, sometimes with a few cycles of chemotherapy before surgery, followed by maintenance tablets or bevacizumab [6, 7]. In a large study of women with extensive stage 3 and 4 cancer, chemotherapy before surgery was no worse for survival than surgery first [8]. If surgery is not possible, chemotherapy is given on its own [6].
In older data from the United States, about 1 in 4 women with stage 4 serous cancer were alive 5 years later [2]. These numbers come from before PARP inhibitor tablets; with newer treatments, many women with a BRCA mutation or HRD-positive cancer have lived for years without the disease coming back [9, 10]. Read more: Stage 4 cancer: what it means and whether it can be treated
Ovarian cancer and fluid in the abdomen (ascites)
Ascites means fluid building up in the abdomen. In ovarian cancer, bloating, swelling or a feeling of pressure in the abdomen and feeling full quickly are common symptoms [4, 6]. Extra fluid that makes the abdomen swell is one of the factors that affect the outlook and the choice of treatment [6].
Fluid in the abdomen does not on its own mean stage 4. If the fluid in the abdomen contains cancer cells but the cancer is still limited to the ovary or fallopian tube, it is stage 1; stage 4 means fluid around the lungs with cancer cells, or cancer that has reached distant organs [5].
Treatment: the cancer itself is treated with surgery and chemotherapy [6]. If there is a lot of fluid and it is uncomfortable, the doctor drains it from the abdomen with a needle (paracentesis); this relieves symptoms well but only for a while, and it may need to be repeated [12]. The drug bevacizumab is especially useful for easing symptoms in women with a lot of fluid in the abdomen [4]. If your abdomen is swelling quickly, you are short of breath or you cannot eat, tell your doctor soon.
Frequently asked questions
What is the life expectancy with ovarian cancer? What is the survival rate?
It depends on the type and stage of the cancer, whether all of the tumour was removed with surgery, BRCA mutations, age and general health [6]. In the United States, more than 9 in 10 women whose cancer is only in the ovary, and about 3 in 10 women whose cancer has spread further, are alive 5 years later [1]. These numbers come from women treated some years ago. Read more: What do cancer survival rates and life expectancy really mean?
Does ovarian cancer come back after treatment?
In advanced cancer, most women go into remission after the first treatment, but in many of them the disease comes back at some point [4]. Cancer that has come back usually cannot be cured, but it can be controlled, and at this stage symptom control and quality of life are very important [3]. If the disease comes back more than 6 months after the last chemotherapy, a specialist team checks whether another operation is possible [7]. Read more: What is cancer recurrence? and if the disease comes back early.
Can I get pregnant after ovarian cancer?
Sometimes, yes. In early-stage cancer, some women who want to have children can have only one ovary and the fallopian tube on the same side removed [6]. Tell your doctor about this wish before surgery. Read: Fertility and sex during cancer treatment.
Does ovarian cancer with fluid in the abdomen mean the end of the road?
I have an ovarian cyst; does that mean I have cancer?
Read about ovarian cysts, warning signs on ultrasound and the role of the CA-125 test: Ovarian cyst or ovarian cancer: how can you tell? and What does a high CA-125 mean?
How curable are other cancers?
The chance of cure differs from one cancer to another. Read: Can cancer be cured?, Is breast cancer curable? and Is pancreatic cancer curable?
Survival evidence by stage, type and treatment (for doctors)
For physicians
Population survival. SEER (diagnosed 2015 to 2021): 5-year relative survival for all stages 52% (36% in 1975 to 1977); localised 92%, regional 71% and distant 32% (27% in 1995 to 1997); 49% of cases in 2018 to 2022 were diagnosed at a distant stage, compared with 57% a decade earlier [1]. 5-year cause-specific survival by histology: serous 43%, endometrioid 82%, mucinous 71% and clear cell 66%; serous carcinomas are mostly diagnosed at stage III (51%) or IV (29%), with survival of 42% and 26%. Germ cell and sex cord-stromal tumours (3% and 2% of cases) are mostly diagnosed at stage I (57% and 64%), with survival of 99% and 98% at stage I and 69% and 41% at stage IV [2].
Surgery and the probability of cure. EORTC 55971 (632 patients with stage IIIC–IV, mostly bulky disease): neoadjuvant chemotherapy and interval debulking vs primary debulking, HR for death 0.98 (90% CI 0.84 to 1.13; P=0.01 for non-inferiority); largest residual tumour 1 cm or less in 41.6% after primary debulking and 80.6% after interval debulking; complete resection of all macroscopic disease was the strongest independent predictor of overall survival [8]. Pan-Asian adapted ESMO guideline: evaluation for primary debulking by a specialised team, aiming at complete cytoreduction (no visible residual disease) [III, A]; paclitaxel 175 mg/m2 with carboplatin AUC 5 to 6 every 3 weeks for 6 cycles is the standard first-line chemotherapy for advanced disease [I, A] [7]. About 20% of women with advanced disease survive beyond 12 years and are effectively cured; the probability of cure depends on primary surgery and chemotherapy eliminating all cancer cells [11].
PARP inhibitor maintenance. SOLO1/GOG 3004 (391 patients with a BRCA mutation; olaparib for up to 2 years): median follow-up 88.9 and 87.4 months; HR for overall survival 0.55 (0.40 to 0.76; P=0.0004, whereas P<0.0001 was required for significance); alive at 7 years 67.0% vs 46.5%, and alive without a first subsequent treatment 45.3% vs 20.6% [9]. PAOLA-1 (olaparib for up to 24 months with bevacizumab for 15 months): in the overall population median OS 56.5 vs 51.6 months (HR 0.92; P=0.4118), with subsequent PARP inhibitor therapy in 45.7% of the placebo arm; in HRD-positive disease HR 0.62 (0.45 to 0.85), 5-year OS 65.5% vs 48.4% and 5-year PFS 46.1% vs 19.2% [10]. Pan-Asian adapted ESMO guideline: germline and/or somatic BRCA testing for all patients with high-grade non-mucinous cancer at diagnosis [I, A]; PARP inhibitor maintenance with or without bevacizumab for BRCA-mutated disease (olaparib for 2 years) or BRCA-wild-type, HRD-positive disease (niraparib for 3 years; olaparib–bevacizumab is also a standard) [I, A]; at first relapse more than 6 months after the last platinum, evaluation for cytoreductive surgery in an experienced centre [I, A] [7].
Ascites. In the systematic review by Becker (32 studies, no randomised trials), paracentesis had a good but temporary effect on symptoms, the evidence on diuretics was conflicting, and peritoneovenous shunts must be balanced against their risks [12]. Bevacizumab is especially useful for symptomatic relief in large-volume ascites [4]. FIGO 2014: malignant cells in ascites or peritoneal washings with tumour limited to the ovary or tube = IC3; pleural effusion with positive cytology = IVA [5].
Scientific evidence
Scientific evidence
4 itemsOverall Survival With Maintenance Olaparib at a 7-Year Follow-Up in Patients With Newly Diagnosed Advanced Ovarian Cancer and a BRCA Mutation: The SOLO1/GOG 3004 Trial
Olaparib plus bevacizumab first-line maintenance in ovarian cancer: final overall survival results from the PAOLA-1/ENGOT-ov25 trial
Neoadjuvant Chemotherapy or Primary Surgery in Stage IIIC or IV Ovarian Cancer
Pan-Asia adapted ESMO Clinical Practice Guideline for the management of patients with newly diagnosed and relapsed epithelial ovarian cancer
Related cancer types
Related questions
References
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Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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