Information for patients with gynaecological cancer Departments of gynaecology, oncology and gynaecological oncology
This booklet gives further information about cancers of the female reproductive system (gynaecological cancers). These include cancer of the cervix, womb (uterus), ovary, vulva and less common gynaecological cancers. This booklet explains the role of the different doctors and nurses looking after you. We hope you find it helpful. We welcome any comments you have so we can improve future editions. Being told about the treatment you may need for gynaecological cancer can be confusing. You will meet many professionals involved with different aspects of your care. Treatment may be offered at St George s Hospital or The Royal Marsden Hospital. At diagnosis, we will give you the name of your key worker. This will usually be your Macmillan nurse specialist. Your key worker will co-ordinate your care and be your main point of contact for any queries and worries you may have. 2
Throughout your treatment, you will be offered a permanent record or summary of consultations between yourself and the doctor. This will normally be a copy of the letter sent to your GP. If you do not get this, please ask your doctor or clinic staff. You will continue to receive copies of letters unless you inform the hospital that you do not want them. Your key worker is: Contact number: 3
Who will be looking after me? Your consultant is in overall charge and supervises the work of a team of clinicians to look after you. This team of people is called the multidisciplinary team (MDT). It will include different specialists involved in treating and managing gynaecological cancers. They will help decide on, perform or help with your investigations, diagnosis and treatments. They can also help you to cope with the effects of the illness on your life. The team members meet every week to discuss treatment plans for all their patients. Any decisions made about you are recorded in your clinical records. MDT members include: Gynaecological cancer surgeons Often, your first treatment will be an operation and your care will be managed by a gynaecological cancer surgeon. Medical oncologist This doctor specialises in the treatment of cancer with drugs, including chemotherapy (anti-cancer drugs). This treatment can happen either at St George s Hospital or The Royal Marsden Hospital. 4
Clinical oncologist This doctor specialises in the treatment of cancer with radiotherapy treatments (high energy x-rays). Most clinical oncologists can also prescribe chemotherapy. If you have radiotherapy, you will be referred to The Royal Marsden Hospital. Clinical nurse specialist (CNS) This nurse will give you and your family information about your cancer and its treatment. They will support you and your family throughout your treatment and help answer your questions. They know that patients, their families and close friends often need someone to talk to about cancer and its treatment. Their full title is Macmillan gynaecological-oncology clinical nurse specialist (CNS). Your CNS can give you information and practical advice on: surgery radiotherapy chemotherapy sex and psychosexual issues menopausal symptoms 5
fertility and infertility information local and national support groups coping with your illness the effects of treatments on your day-today activities financial worries help at home. Radiologist A radiologist is a doctor who uses x-rays and other types of images of your body to diagnose and manage your condition. As well as x-rays, you may also have computerised tomography (CT) scans, magnetic resonance imaging (MRI) scans and ultrasound. Histopathologist A histopathologist is a doctor who looks at small samples from your body under the microscope to help with diagnosis and treatment. 6
Other professionals You may also meet other different specialists throughout your treatment to help you with specific problems. For example: physiotherapist supports patients who have operations by giving them exercises to help breathing or strengthening muscles. social worker provides information and advice about what practical support is available in your own home. They can arrange a formal assessment of your needs. inpatient occupational therapist supports with any physical, emotional or social problems you may have and helps you carry out day-to-day activities safely. dietitian offers information, advice and support to make sure you eat and drink enough of what is best for you during your treatment. oncology counsellor supports you and your family while you are having chemotherapy. If you feel it would be 7
helpful to talk to the counsellor, please ask your CNS. women s health counsellor supports you with women s health issues related to your cancer such as relationships, fertility and infertility. hospital palliative care team nurses and doctors who help people living with a serious illness and their families. They can help you cope with symptoms such as pain, nausea, vomiting and worry. If you feel it would be helpful to talk to the palliative care team, please ask your CNS. If you feel it would be helpful to meet any of these people, please ask your nurse specialist or discuss it with another member of your team. 8
Where will my care and treatment take place? Where you need to go for your appointments will depend on the treatment you are offered. Surgery Surgical outpatient clinics are on Monday mornings with Mr Ind and Thursday afternoons with Mr Barton, in the gynaecological outpatient s clinic, ground floor, Lanesborough wing, St George s Hospital. Your operation may be performed by other gynaecology surgeons on other days of the week. A joint gynaecology-oncology clinic is held on the second Monday of each month. This clinic involves the gynaecological cancer surgeons, medical oncologist and clinical oncologist. If you are admitted for surgery or a procedure under general anaesthetic (whether as a day case or with an overnight stay) you will usually be admitted to Champney s ward, 4th floor, Lanesborough wing, St George s Hospital. The visiting hours on Champney s ward are between 2 and 8pm. 9
Chemotherapy If you are offered chemotherapy, you may be given it at St George s Hospital or The Royal Marsden Hospital. At St George s, you will be seen in the oncology outpatient clinic, ground floor, St James wing. This clinic is usually held every Tuesday but may also be on a Wednesday or Friday. Chemotherapy is usually given on the Trevor Howell Oncology Day Unit, 3 rd Floor, Lanesborough wing. Occasionally, patients may need to be admitted to Trevor Howell ward or Gordon Smith ward for some chemotherapy treatment plans. Specialist chemotherapy nurses will give you your chemotherapy. They will be able to answer your questions and give you further written information about your treatment. When you have chemotherapy, you will be given an alert card telling you what symptoms to look out for and what to do about them. You may be given appointments at The Royal Marsden Hospital to be given chemotherapy. 10
Radiotherapy Radiotherapy is provided at The Royal Marsden Hospital, generally as an outpatient. It is usually carried out each day over several weeks. The Royal Marsden Hospital has two branches, in Chelsea and Sutton, and most radiotherapy can be given from both, with brachytherapy treatment only delivered at the Chelsea branch. We will organise your appointment with the clinical oncologist at the Royal Marsden Hospital. You will be able to discuss any questions or concerns about radiotherapy before your treatment starts. Follow-up care We will give you an appointment for followup care at the end of your treatment. Will I be part of any research? We are constantly trying to improve treatments, and need to carry out research to do this. We may ask if you would like to be included in a type of research called a clinical trial. Research nurses can answer any questions about the proposed trial but you do not have to take part if you do not want to, and this will not affect any care you receive. 11
Where can I find more support? The Macmillan information and support centre, ground floor, Grosvenor wing offers information and support to people with cancer and their families and friends. They can give information about: cancer cancer treatments and their effects cancer services complementary therapies benefits and grants support services within St George s and local self-help and support groups. You can pop in to the centre or call them on 020 8725 2677. Staff will guide you through the information and give you advice and support. Having cancer may affect you and your family s financial situation and your key worker or specialist nurse will be able to tell you about any help you can get. The Macmillan Citizens Advice Bureau (CAB) for South West London can also give free, confidential advice on family finance including any benefits you are entitled to. 12
You can call the Macmillan CAB on 020 7042 0332 10am-12.30pm or 2.30-4pm, or you can contact them via their website: www.wandsworthcabx.org.uk/macmillan If you need a sickness certificate for your employer you can get this from your GP. Free prescriptions People undergoing treatment for cancer and the effects of cancer treatment are eligible for free prescriptions. You will need to show an exemption certificate to get free prescriptions, which you need to apply for by completing form FP92A which you can get from your GP surgery. Help with interpreting Let us know two weeks before your appointment if you need an interpreter. If your appointment is at St George s Hospital, call your clinical nurse specialist or your keyworker to arrange. For The Royal Marsden Chelsea, call: 020 7352 8171. For The Royal Marsden Sutton, call 020 8642 6011 and ask for the outpatient department. 13
Telephone interpreters are also available. Hospital transport To check if you qualify for hospital transport call: St George s Hospital transport service on 020 8725 0808 The Royal Marsden Hospital transport on 020 7811 8305. Contact details Consultant Gynaecological Oncology Surgeons Secretary to Mr Des Barton 020 8725 0188 and Mr Thomas Ind Consultant Gynaecological Surgeons Secretary to Mr Paul Carter 020 8725 2538 Secretary to Mr Paul Bulmer 020 8725 2088 and Miss Devi Rao Secretary to Mr Kevin Hayes 020 8725 0155 Consultant Medical Oncologist Secretary to Dr Fiona Lofts 020 8725 3233 Consultant Clinical Oncologist Secretary to Dr Susan Lalondrelle (Royal Marsden Hospital) 020 8661 3272 14
Macmillan Gynaecological-Oncology Clinical Nurse Specialist 020 8266 6541 Champney s ward 020 8725 2085 Admission/ 020 8725 0522 Pre-Operative Assessment /0520 Colposcopy Clinic 020 8725 0900 Trevor Howell ward 020 8725 1083 Gordon Smith ward 020 8725 5897 Oncology dietician 020 8725 3049 Chemotherapy day unit 020 8725 3637 Macmillan Information and 020 8725 2677 Support Centre Macmillan Citizen s Advice Bureau Advice Service 020 7042 0332 15
You can get support for particular kinds of gynaecological cancer from the organisations below: Jo s Trust (cervical cancer) Tel: 020 7936 7498 Web: www.jostrust.org.uk Ovacome (ovarian cancer) Tel: 0845 371 0554 Web: www.ovacome.org.uk Gynae C (all types of gynaecological cancer) Tel: 01793 491 116 Web: www.gynaec.co.uk/ The Daisy Network (premature menopause caused by cancer treatment) www.daisynetwork.org.uk Menopause Matters (general menopause issues) www.menopausematters.co.uk 16
Additional services Patient Advice and Liaison Service (PALS) PALS can offer you on-the-spot advice and information when you have comments or concerns about our services or the care you have received. You can visit the PALS office between 9am and 5pm, Monday to Friday in the main corridor between Grosvenor and Lanesborough wing (near the lift foyer). Tel: 020 8725 2453 Email: pals@stgeorges.nhs.uk NHS Choices NHS Choices provides online information and guidance on all aspects of health and healthcare, to help you make decisions about your health. Web: www.nhs.uk NHS 111 You can call 111 when you need medical help fast but it s not a 999 emergency. NHS 111 is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones. Tel: 111 Reference: ONO_GYC_01 Published: July 2016 Review date: July 2018 17