NCCN Guidelines for Patients
Ovarian Cancer, Version 1.2017
Cancer staging Cancer grades and cell subtypes | Cancer care plan
Cancer grades and cell
Ovarian cancer is also classified based on what
the cancer cells look like when viewed with a
microscope. A pathologist will examine the cancer
cells to find out the cancer grade and cell subtype. A
pathologist is a doctor who’s an expert in testing cells
with a microscope to identify disease. Testing cancer
cells from tissue removed during surgery is the only
way to find out the cancer grade and cell subtype.
The cancer grade is a rating of how much the cancer
cells look like normal cells. The cancer grade is
a sign of how fast the cancer will likely grow and
spread. Based on the features of the cancer cells,
the pathologist will score the cancer as Grade 1, 2,
cancer cells look similar to normal
cells. This is also called low grade. These
cancer cells grow slowly and are less likely to
cancer cells look more abnormal than
Grade 1, but not as abnormal as Grade 3.
These cancer cells grow at a medium speed.
They are more likely to spread than Grade 1,
but less likely than Grade 3.
cancer cells look very different from
normal cells. This is also called high grade.
These cancer cells grow faster and are the
most likely to spread.
Some pathologists describe the grading in only two
classes: high grade or low grade. Low grade includes
the Grade 1 definition above. High grade includes the
Grade 2 and Grade 3 definitions.
Ovarian cancer cell subtypes
Ovarian cancer is divided (classified) into smaller
groups called cell subtypes. The cell subtype
is based on the features of the cancer cells.
A pathologist will view the cancer cells with a
microscope to find out the cell subtype. There are
four main cell subtypes of ovarian cancer. Serous is
the most common. The other main cell subtypes are
mucinous, endometrioid, and clear cell. However, all
four subtypes are often treated in the same way.
Cancer care plan
Your treatment team
Treating ovarian cancer takes a team approach.
Gynecologic oncologists and medical oncologists
often work closely together to plan the best treatment
for ovarian cancer. A gynecologic oncologist is a
doctor who’s an expert in surgery to treat cancers
that start in a woman’s reproductive organs. A
medical oncologist is a doctor who is an expert in
treating cancer with chemotherapy and other drugs.
NCCN experts recommend that a gynecologic
oncologist should perform the initial surgery for
ovarian cancer when possible.
Your primary care doctor can also be part of your
team. He or she can help you express your feelings
about treatments to the team. Treatment of other
medical problems may be improved if he or she is
informed of your cancer care. Besides doctors, you
may receive care from nurses, social workers, and
other health experts. Ask to have the names and
contact information of your health care providers
included in the treatment plan.
There is no single treatment practice that is best for
all patients. There is often more than one treatment
option, including clinical trials. Clinical trials study
how well a treatment works and its safety.