Clinical reference

Ovarian cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD28.01 - condition scope only, no dose · NICE NG12: Suspected cancer: recognition and referral (recommendation 1.5) - https://www.ncbi.nlm.nih.gov/books/NBK555330/ · No dose - referral pathway, no medicine given in primary care

Verified against2 documents

No dose - referral pathway, no medicine given in primary care
Ovarian cancer - disease-level clinical article (ovarian-cancer-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

Most patients have vague symptoms - bloating, distention, early fullness, fatigue, bowel changes, urinary symptoms, back pain, painful sex, and weight loss [abdominal distension · back pain · fatigue · weight loss]
Abnormal uterine bleeding is not typically a presenting symptom of ovarian cancer [abnormal uterine bleeding]
Early disease is often mild or silent, so symptoms get missed and attributed to other causes
Cerebellar degeneration from a paraneoplastic reaction can cause unsteadiness, slurred speech, jerky eye movements, dizziness, and double vision, sometimes years before the tumor is found [dizziness · double vision · slurred speech · unsteadiness]
Paraneoplastic hypercalcemia can present as confusion, fatigue, constipation, belly pain, and increased thirst and urination [abdominal pain · confusion · constipation · excess thirst · fatigue]

Signs — what you find (4)

Exam may reveal a palpable pelvic mass, ascites, or reduced breath sounds from a pleural effusion in advanced disease [ascites · pelvic mass]
A hard umbilical nodule (Sister Mary Joseph nodule) is a rare finding from metastasis [metastasis · umbilical lump]
A sudden crop of seborrheic keratoses can be a clue pointing to an occult malignancy
An irregular, firm, fixed, nodular mass or ascites on pelvic exam warrants imaging workup [ascites]

Tests (8)

CA-125 above 35 U/mL in a postmenopausal woman signals a high risk of malignancy
CA-125 is raised in most advanced cases but only about half of early-stage disease, so a normal level does not exclude cancer
CA-125 also rises with pregnancy, other cancers, and inflammatory conditions such as PID, adenomyosis, or endometriosis
HE4 is more sensitive than CA-125 in early disease, while CA-125 is more sensitive in late-stage disease
Transvaginal ultrasound is the first imaging test, looking for papillary or solid components, irregularity, ascites, and strong color Doppler flow
O-RADS 5 lesions carry a malignancy risk of at least 50 percent and warrant urgent gynecologic oncology referral
MRI is used when ultrasound findings are equivocal or CA-125 is normal, since it characterizes masses with high specificity
CT is often done before MRI to stage disease extent and plan surgery, though MRI better visualizes the ovarian tumor itself

If not this — what else fits (8)

Colon cancer is on the differential for an ovarian mass
Gastric adenocarcinoma is on the differential for ovarian cancer
Metastatic gastrointestinal carcinoma should be considered in the differential
Ovarian torsion is on the differential list
Peritoneal cyst is a differential consideration
Retroperitoneal mass should be considered in the differential
Uterine fibroids should be considered in the differential
Endometriosis is on the differential list for an ovarian mass

SourceStatPearls "Epithelial Ovarian Cancer" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line

Adult dose and duration

Malignant ovarian tumour; a Cairo GP recognises red-flag symptoms and refers urgently to gynae-oncology for surgical staging and chemotherapy, which are outside primary-care prescribing. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Malignant ovarian tumour; a Cairo GP recognises red-flag symptoms and refers urgently to gynae-oncology for surgical staging and chemotherapy, which are outside primary-care prescribing.

Cautions

No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
RED FLAG - High-risk adnexal lesions (O-RADS 5) with malignancy risk >=50% require immediate referral to a gynecologic oncologist.
RED FLAG - Irregular, firm, fixed, and nodular pelvic masses or ascites should prompt further evaluation with imaging studies.
RED FLAG - Persistent abdominal bloating or distension, unexplained weight loss, or postmenopausal ovarian enlargement on ultrasound.

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