Understanding Gynaecological Cancers - Become an NHS ...
Understanding Gynaecological Cancers - Become an NHS ...
Understanding Gynaecological Cancers - Become an NHS ...
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316What is c<strong>an</strong>cer?C<strong>an</strong>cer is a term used to describe a growth of abnormal cells.Sometimes these abnormal cells grow at a much quicker rate th<strong>an</strong>normal cells. The abnormal cells stick together <strong>an</strong>d form acluster/growth. Doctors call this abnormal cluster of cells a‘tumour’. If the abnormal cells first start growing in the ovary, as <strong>an</strong>example, it is called a malign<strong>an</strong>t primary ovari<strong>an</strong> tumour. If someof the abnormal ovari<strong>an</strong> cells break off <strong>an</strong>d travel in the blood orlymphatic circulation, they may start to grow in other areas of thebody, eg in the abdomen or pelvis. This new growth is calledsecondary tumour or metastasis.Types of Gynaecology c<strong>an</strong>cerThere are different types of gynaecological c<strong>an</strong>cer. These include :C<strong>an</strong>cer of the OvaryPrimary PeritonealC<strong>an</strong>cer of the Fallopi<strong>an</strong> TubeC<strong>an</strong>cer of the WombC<strong>an</strong>cer of the CervixC<strong>an</strong>cer of the VulvaC<strong>an</strong>cer of the VaginaThe Gynaecology Oncology TeamDuring investigations <strong>an</strong>d once you have been diagnosed with agynaecological c<strong>an</strong>cer a Multi Disciplinary Team meeting bringstogether all the specialists involved in your care. This meetingfocuses on your diagnosis <strong>an</strong>d begins to discuss the treatment pl<strong>an</strong>most appropriate for you.This meeting takes place every Thursday <strong>an</strong>d the outcome of themeeting will then be shared <strong>an</strong>d discussed with you at <strong>an</strong> Outpatientconsultation.Fin<strong>an</strong>cial Help & AdviceDue to your illness your income may have gone down <strong>an</strong>d youmay need fin<strong>an</strong>cial help. The Department of Work <strong>an</strong>dPensions (DWP) will be able to advise you. The DWPprovides state benefits, gr<strong>an</strong>ts <strong>an</strong>d lo<strong>an</strong>s.Benefit Enquiry LineProvides information <strong>an</strong>d advice about social security benefitentitlements.Freephone: 0800 88 22 00Once you have your application form, questions regardingDisability Living Allow<strong>an</strong>t (DLA) or Attend<strong>an</strong>ce Allow<strong>an</strong>ce (AA)applications c<strong>an</strong> be discussed by ringing the number below:Freephone: 08457 123456How do I find out more?Age Concern Buckinghamshire - Information, support <strong>an</strong>dadvice for those over the age of 65 offering contacts for a wider<strong>an</strong>ge of useful services.Available 9am – 4pm weekdays Monday – Friday.Tel: 01296 431911Website: www.ageconcernbucks.org.ukEmail: acb@ageconcernbucks.org.ukC<strong>an</strong>cer Research UKFor clear <strong>an</strong>d easy to underst<strong>an</strong>d information about c<strong>an</strong>cer <strong>an</strong>dc<strong>an</strong>cer treatments <strong>an</strong>d <strong>an</strong>swers to questions about c<strong>an</strong>certhrough a confidential support line.Available Monday - Friday 9am- 5pmFree phone: 0808 800 4040Website: www.c<strong>an</strong>cerhelp.org.uk
154C<strong>an</strong> I Travel?If you are travelling long dist<strong>an</strong>ces by rail or air, advise theoperator when booking your seats, as additional help is oftenavailable to you. You will need travel insur<strong>an</strong>ce when travellingabroad. This c<strong>an</strong> often be expensive <strong>an</strong>d it is advisable to shoparound for the best deal (it is usually cheaper 6 months aftercompletion of last treatment). Ask your GP for advice if you aretravelling with drugs, particularly morphine, as you mayrequire a covering letter.Practical HelpFree Prescriptions - All c<strong>an</strong>cer patients are now entitled tofree prescriptions. Please complete a form provided by yourGP so that you c<strong>an</strong> access this as soon as possible.The members of this team include your gynaecology consult<strong>an</strong>t,oncologist, a pathologist, a radiologist <strong>an</strong>d your gynaecologyc<strong>an</strong>cer nurse specialist.Hospital Admissions<strong>Gynaecological</strong> surgery is carried out at Stoke M<strong>an</strong>devilleHospital <strong>an</strong>d patients recover on ward 16b. Some patients arereferred to the Gynae-Oncology Surgeons at The ChurchillHospital, OxfordfOur Gynaecology C<strong>an</strong>cer TeamName Specialty Location Contact details(Secretaries)Mr. Dami<strong>an</strong>EustaceGynae/Oncology Wycombe 01494-425512Social Services - Information <strong>an</strong>d advice will be available fromyour local social services department <strong>an</strong>d if you meet certaincriteria, a r<strong>an</strong>ge of services will be open to you. These mayinclude: personal care, meals, laundry, equipment to use athome (a fin<strong>an</strong>cial charge may be made for some services).To find out more about Social Services contact:Aylesbury Office 01296 395000High Wycombe Office 01494 475000Blue Badge Application - You may well be entitled to a bluedisabled badge for parking the car. To apply for a blue badgecontact Bucks County Council on 01296 382902 or apply on linevia the Bucks County Council Website.Miss GeraldineTaskerGynae/OncologyStokeM<strong>an</strong>devilleDr.Sally Trent Oncology Wycombe/StokeM<strong>an</strong>devilleMr.RobertoTozzi, LeadConsult<strong>an</strong>t inGynaeoncology)Fr<strong>an</strong>cesca LisGynae/oncologyClinical NurseSpecialistThe ChurchillHospital, OxfordWycombe/StokeM<strong>an</strong>devilleLisa D’Uva Nurse Specialist Wycombe/StokeM<strong>an</strong>deville01296-31616301494-426258(WH)01296-316555(SMH)01865-235355(Specialist Nurses)01296-316863(<strong>an</strong>swer phone)01296-316863
514Treatments for Gynaecology C<strong>an</strong>cerWhat treatment will I be offered? In general there are threetypes of treatment used in the m<strong>an</strong>agement of gynaecologyc<strong>an</strong>cer:• Surgery• Chemotherapy (drug treatment)• Radiotherapy (X-ray treatment)As described previously the type of treatment offered will dependon a number of factors, including how adv<strong>an</strong>ced your c<strong>an</strong>cer is<strong>an</strong>d your fitness to undergo the treatment. There are individualinformation booklets available which will be given to you at yourtime of diagnosis. Should you have questions about yourtreatment following <strong>an</strong> appointment then feel free to call yourgynaecology c<strong>an</strong>cer nurse specialist also known as your keyworker, to discuss <strong>an</strong>y concerns you may have.Surgery for <strong>Gynaecological</strong> <strong>C<strong>an</strong>cers</strong>Types of hysterectomy - There are different types ofhysterectomy. The operation that you have depends on the typeof c<strong>an</strong>cer you have <strong>an</strong>d its stage <strong>an</strong>d grade. The stage of yourc<strong>an</strong>cer describes its size <strong>an</strong>d whether it has spread. The grade ishow the cells look when examined under a microscope. This gives<strong>an</strong> idea of how the c<strong>an</strong>cer may behave.Why women may have a hysterectomy - A hysterectomy is oneof the main treatments for c<strong>an</strong>cers of the:ovary• womb• cervix• fallopi<strong>an</strong> tubes.Relaxation hour –a group running at Stoke M<strong>an</strong>devilleHospital, designed to provide seated relaxation with calmingwords <strong>an</strong>d gentle music for c<strong>an</strong>cer patients, relatives <strong>an</strong>dcarers.Look Good Feel Better Masterclasses – dedicated toimproving the confidence <strong>an</strong>d wellbeing of people undergoingc<strong>an</strong>cer treatment. Aims to improve self-image <strong>an</strong>d appear<strong>an</strong>cethrough free skincare <strong>an</strong>d make-up that teach new skills <strong>an</strong>dtechniques through friendly, supportive group sessions.‘Lavender Girls’ –a gynae-oncology patient support groupwhich meets once a month on a Tuesday from 10am to 12pm.Includes group discussions <strong>an</strong>d/or a talk /activity from ahealthcare professional on a topic of the groups choice egrelaxation techniques, creative arts, diet <strong>an</strong>d nutrition, make-upetc.Moving on with Confidence - This is a six week course forpeople after c<strong>an</strong>cer treatment.It is aimed at helping you cope <strong>an</strong>d adjust better to life afteryour c<strong>an</strong>cer treatment with more confidence <strong>an</strong>d to move on.More information <strong>an</strong>d how to book <strong>an</strong>y of these servicesare enclosed in your ‘C<strong>an</strong>cer Information Pack’, oralternatively telephone: 01296 316954 for further details.The Clinical Psychology Service - A clinical psychologyservice is available for you <strong>an</strong>d your family. A referral to thisservice c<strong>an</strong> be arr<strong>an</strong>ged through your gynaecology nursingteam. The service offers <strong>an</strong> opportunity to talk one to one witha psychologist.
136The C<strong>an</strong>cer Education, Information <strong>an</strong>d Support ServiceOffer information <strong>an</strong>d support to <strong>an</strong>yone who has concerns aboutc<strong>an</strong>cer, their relatives, friends <strong>an</strong>d carers. The team ensure thatpeople affected by c<strong>an</strong>cer have access to good quality,comprehensive <strong>an</strong>d appropriate information <strong>an</strong>d support.The service is staffed by health professionals <strong>an</strong>d supported bytrained volunteers. Some of our volunteers have personalexperience of living with c<strong>an</strong>cer.The service c<strong>an</strong> put you in touch with complementary therapists,Citizens Advice Bureau advisors, <strong>an</strong>d other local <strong>an</strong>d nationalsupport groups. Services include:Complementary therapies - include Indi<strong>an</strong> head massage, reiki,aromatherapy, massage, reflexology <strong>an</strong>d acupuncture, <strong>an</strong>d as thename suggests c<strong>an</strong> be used alongside your conventional treatmentprogramme. Our therapists are all volunteers <strong>an</strong>d highly trained.Welfare Benefits Advisor - (funded by Macmill<strong>an</strong>).We have a Benefits advisor that works at Stoke M<strong>an</strong>deville onThursday <strong>an</strong>d Friday each week. They work within the CitizenAdvice Bureau <strong>an</strong>d offers independent advice relating tobenefits, employment, pensions <strong>an</strong>d housing. They c<strong>an</strong> alsohelp in completing application forms for gr<strong>an</strong>ts <strong>an</strong>d benefits.Wig fitting <strong>an</strong>d hair <strong>an</strong>d nail care – weekly clinics are held atStoke M<strong>an</strong>deville <strong>an</strong>d Wycombe Hospitals on a Monday for wigfitting. Please see the ‘Wig Supply <strong>an</strong>d Fitting Service’ leafletfor details of how to book <strong>an</strong> appointment.Creative Arts –a group running at Stoke M<strong>an</strong>deville Hospital,designed to provide a recreational, relaxing <strong>an</strong>d general artsession for c<strong>an</strong>cer patients <strong>an</strong>d their carers.Women with vaginal c<strong>an</strong>cer may sometimes need a hysterectomyif their c<strong>an</strong>cer has spread further. <strong>C<strong>an</strong>cers</strong> of these org<strong>an</strong>s aresometimes called gynaecological c<strong>an</strong>cers.Surgery is usually carried out in specialist c<strong>an</strong>cer centres or unitsby surgeons who are experts in this type of operation.Sometimes treatment is a combination of surgery, chemotherapy/radiotherapy, depending on your type of c<strong>an</strong>cer, stage <strong>an</strong>d grade.You will be given <strong>an</strong> individualised treatment pl<strong>an</strong>, <strong>an</strong>d furtherdetailed information following the Multidisciplinary Team Meetingor Consultation with your Gynae-oncology Surgeon.Chemotherapy for <strong>Gynaecological</strong> <strong>C<strong>an</strong>cers</strong>Chemotherapy is a general term for the treatment of c<strong>an</strong>cerusing drugs. The drugs that are used are designed to kill offc<strong>an</strong>cer cells while causing less damage to normal cells.There are m<strong>an</strong>y different types of chemotherapy drugs which c<strong>an</strong>be used on their own or, more commonly, in combinations.Patients with different types of gynaecological c<strong>an</strong>cer arelikely to receive different combinations of chemotherapydrugs.Chemotherapy is, in general, administered as <strong>an</strong> outpatient atWycombe, Stoke M<strong>an</strong>deville <strong>an</strong>d/or the Churchill Hospital. Thelength of treatment varies depending on the type of drugs to beused <strong>an</strong>d the type of gynaecological c<strong>an</strong>cer.If it is felt that chemotherapy would be the most appropriatetreatment for you, then you would be referred to a Consult<strong>an</strong>tOncologist.
712Our Consult<strong>an</strong>t Oncologists are based at the Churchill Hospital,Oxford but they have regular weekly clinics at the Outpatientdepartments at Wycombe or Stoke M<strong>an</strong>deville.If you <strong>an</strong>d your oncologist decide that chemotherapy is the righttreatment for you then you will be given written information abouteach drug <strong>an</strong>d the possible side effects. These side effects <strong>an</strong>dyour care during the treatment will be explained in detail beforethe treatment begins. You will have plenty of time to askquestions <strong>an</strong>d even though you will sign a consent form for thetreatment you c<strong>an</strong> choose to stop the treatment at <strong>an</strong>ytime.Useful Contact Telephone Numbers for the ChemotherapyUnitsHospital SiteC<strong>an</strong>cer Care <strong>an</strong>d HaematologyUnit, Room 10, Stoke M<strong>an</strong>devilleSunrise Chemo Unit, Ward 5A,Wycombe HospitalChemotherapy Coordinator,Churchill HospitalRadiotherapy for Gynaecology C<strong>an</strong>cerTelephone Number01296 31512501494 42623801865 235022External radiotherapy - This is given by directing painlesshigh-energy beams at the area of the c<strong>an</strong>cer, while doing aslittle harm as possible to normal cells.Radiotherapy works by killing c<strong>an</strong>cer cells <strong>an</strong>d c<strong>an</strong> be used onits own to treat c<strong>an</strong>cer though it may also be given as part of acombined treatment with chemotherapy.Throughout your diagnosis, treatment <strong>an</strong>d afterwards, try toaccept that these reactions are normal. If you feel you need to,allow yourself time to cry. This c<strong>an</strong> often be a helpful way ofdealing with bottled up emotions. Learning a relaxationtechnique c<strong>an</strong> also be very helpful as it c<strong>an</strong> help you switch offyour mind from worries <strong>an</strong>d also relax your body.How do I tell the children?If you have children it may seem natural to try <strong>an</strong>d protect themfrom the news. Even if they have not been told about thediagnosis, it is not unusual for children to know from thereactions of others that something is wrong. Occasionallywhen children are not included in the diagnosis in some way,their imaginations c<strong>an</strong> take over. This c<strong>an</strong> be more frighteningfor them th<strong>an</strong> the truth. It is therefore recommended thatchildren are given time to talk about the ch<strong>an</strong>ges that arehappening around them.It c<strong>an</strong> be helpful to explain to children that it is normal for them toexperience some strong emotions <strong>an</strong>d you may notice somech<strong>an</strong>ges in their behaviour. It is import<strong>an</strong>t for them to discuss <strong>an</strong>yworries with you openly. Sometimes taking them to hospital visits<strong>an</strong>d introducing them to staff c<strong>an</strong> help reduce some of their fears.There are a number of very useful books, which have beenwritten specifically for children on the subject of c<strong>an</strong>cer inthe family. A list of reading material for children is availablefrom Macmill<strong>an</strong> C<strong>an</strong>cer Support <strong>an</strong>d Winston’s Wish. Thespecialist nursing team c<strong>an</strong> also access some useful books<strong>an</strong>d information. (See page 17 for website information)If you have concerns about ch<strong>an</strong>ges in a child’s behaviouror emotional state, it may be also useful to discuss thingswith your GP. Our Macmill<strong>an</strong> Clinical Psychologist c<strong>an</strong> alsohelp with family counselling.
910Radiologist - A doctor who undertakes <strong>an</strong>d reports x-rays, MRI,<strong>an</strong>d CT <strong>an</strong>d perform CT guided biopsies <strong>an</strong>d ultra sounds.Community Specialist Palliative Care Nurses/Iain RennieNurses - They offer specialist advice, emotional support,symptom control, <strong>an</strong>d information to c<strong>an</strong>cer patients <strong>an</strong>d theircarers. They do not provide ‘h<strong>an</strong>ds on care’ butwill visit <strong>an</strong>d offer advice <strong>an</strong>d support to you <strong>an</strong>d your family athome. Iain Rennie nurses are not available in the Aylesbury area -this is covered by the Community Specialist Palliative CareNurses. Referral is via your Specialist Nurse or GP. If you havebeen referred the numbers are as follows:Wycombe <strong>an</strong>d South Bucks Team - 01494 877200Aylesbury area - 01296 332600(based at Florence Nightingale Hospice)Tring area - 01442 890444Dietiti<strong>an</strong> - If you have problems with your dietary intake, appetiteor maintaining your weight, nurses at each point of your treatmentc<strong>an</strong> advise you on maximum nutrition. There is a Macmill<strong>an</strong>dietiti<strong>an</strong> who you c<strong>an</strong> be referred to after <strong>an</strong> initial assessment ofyour needs.Research Nurses - They are involved in supporting patients whochoose to participate in clinical trials. They work closely with ourOncologists <strong>an</strong>d will see patients during clinic appointments.If you would like information about a particular trial please ask youroncologist or your gynaecology c<strong>an</strong>cer nursing team, or visitwww.macmill<strong>an</strong>.org.uk or Target Ovari<strong>an</strong> C<strong>an</strong>cer atwww.targetovari<strong>an</strong>c<strong>an</strong>cer.org.ukDistrict Nurses (DN) - They provide the nursing support youneed at home. You c<strong>an</strong> access your DN via your GP or through areferral by your specialist nurse.What Happens After Treatment?Regardless of the treatment you are offered, once this has beencompleted you will continue to be reviewed regularly in the clinicby your oncologist. Your Gynaecology Oncology Nurse Specialistis usually present at your clinic appointments.If you feel you need to see your consult<strong>an</strong>t sooner th<strong>an</strong> yourbooked appointment then do talk this through with your specialistnurse who may be able to arr<strong>an</strong>ge this.For advice <strong>an</strong>d support throughout your treatment <strong>an</strong>d carecontact your gynaecological oncology nursing team whoare available Monday to Friday, 9am – 4pm. The nursingteam are busy in clinics on Wednesdays <strong>an</strong>d Thursdays but<strong>an</strong> <strong>an</strong>swer machine is in place at Stoke M<strong>an</strong>devilleHospital, <strong>an</strong>d messages c<strong>an</strong> be accessed from WycombeHospital. Please leave your name <strong>an</strong>d a contact number<strong>an</strong>d we will get back to you as soon as we c<strong>an</strong> - althoughthis may not always be on the same working day.A Nurse Led clinic is available via appointment in the C<strong>an</strong>cerCare <strong>an</strong>d Haematology Unit (CCHU) at Stoke M<strong>an</strong>devilleHospital, for patients to come <strong>an</strong>d discuss their problems/concerns. The CNS will telephone you beforeh<strong>an</strong>d to discusswhat they c<strong>an</strong> offer in the clinic <strong>an</strong>d to book <strong>an</strong> appointment at aconvenient time.Nurse Specialist Holistic AssessmentIn order to help us support you in the best way possible we will,at regular intervals, be offering you a formal opportunity to talkabout <strong>an</strong>y particular worries or concerns you may have. We usea form called a ‘Distress Thermometer’ <strong>an</strong>d this is structured in away that highlights the m<strong>an</strong>y different worries people c<strong>an</strong>experience. All of them are areas that you c<strong>an</strong> share with thegynaecological nursing team.
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