Gynaecology
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| Contact telephone number: 01624 282418 |
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After care plan
This patient information document is to provide you with advice and information of your planned after care following treatment for gynaecological cancer.
Once you have completed treatment you will not need to attend the clinic regularly, but you will remain under our care for the next five years. This means that you will not have to attend regular hospital appointments; instead, you can quickly gain access to the gynaecology team and hospital when you need to.
There is good evidence to show that attending hospital for regular check-ups does not help prevent cancer returning and does not increase life expectancy.
Research suggests that if gynaecological cancer does come back many patients will notice symptoms rather than it being picked up by a doctor or nurse. Also, some women delay reporting symptoms because they have a routine appointment.
Some women find attending regular appointments helpful as it provides reassurance whilst other women find attending hospital regularly makes them feel anxious unless they have something specific, they want to discuss.
The risk that cancer will come back is different for every woman. By having the treatment recommended by your medical team you have minimised your personal risk as much as possible. It is not uncommon to have worries about the risk of cancer coming back.
Treatment summary
When you visit the clinic for the final time you will receive a treatment summary regarding your care.
This includes:
- Any follow up scans you may need if requested
- Further help and support
- How to contact the team
A holistic needs assessment will also be carried out which is a discussion about your physical, emotional, and social needs. This will also provide you with the opportunity to discuss any concerns or questions you may have.
Possible side effects of treatment
All treatments (surgery, chemotherapy, and radiotherapy and hormone therapy) may leave you with side effects and some of these can last longer than others.
Not everyone will experience side effects, but some patients may experience more difficulty with them than others.
Below are some of the common side affects you may experience:
- Menopausal related side effects
- Fatigue (tiredness)
- Sexual, relationship and body image issues
What symptoms do I need to look for?
It is important to know that survival rates for gynaecological cancer are improving all the time. However, cancer can sometimes return. There is no maximum time span as to when cancer can return but the risk reduces over time.
It is important that you are aware of what to look out for and what to do if you become concerned about anything.
Gynaecological cancer can return:
- In the vaginal vault where the cervix used to be
- Pelvic abdominal side wall
- Laparoscopic or wound sites
- Elsewhere in the body (distant recurrence also known as metastatic disease)
Everyone has aches and pains, but when you have had a cancer, you may be more aware of them and may be concerned that any pain is related to cancer.
Included below is a summary of symptoms that you may want to report to your gynaecology specialist nurse or your GP.
If you experience any of these symptoms it does not necessarily mean that your cancer has returned, as they can be caused by many other common conditions, but it may mean that you should get them checked out by the team.
Getting a recurrence or a new cancer can be frightening, but it is important to remember that if cancer returns, it can usually be treated.
Summary of symptoms you should report
- Vaginal bleeding or discharge
- Bleeding after intercourse
- Abdominal pain and/or bloating
- Pelvic pain
- Back pain
- Unexplained weight loss
- Loss of appetite
- Leg swelling
- Persistent change in bowel habit
- Persistent problems in passing urine
Younger women
Younger women may have different needs at the end of treatment such as:
- The impact of treatment upon your fertility
There are various support groups available locally and on social media specifically for younger women. Please also see the Macmillan website https://www.macmillan.org.uk/
Feelings and emotions
Everyone will have different feelings when they no longer need to see their medical team regularly. Some people feel relieved that they can start to get their lives back to normal, others may be concerned about what can happen in the future and anxious about losing contact with the hospital where they received their treatment.
Most people worry about the cancer coming back at times. This is very normal and usually these anxieties lessen with time.
Realising that there is a problem and getting help is the most important thing you can do. While it is normal to feel low from time to time, sometimes you may find the way you are feeling is interfering with your enjoyment of life.
It may also help to contact a local or national support organisation such as the ones listed within the ‘Local support services‘ section which can be found a little further down this information.
Who do I contact if I have a concern?
You should contact your gynaecology cancer nurse specialist (CNS) by telephone about any new symptoms that you are concerned about or other issues you may have. The aim of the telephone service is to provide helpful advice and allow you to have rapid access back to the team as required.
When you reach five years following treatment, your care will be transferred back to your GP and you would need to be re referred into the service.
If your nurse advises you that you need to be seen back in one of our clinics because of any symptoms you are experiencing, they will ensure you are offered an appointment within two weeks. Further investigations may be needed and an outpatient appointment arranged to receive the results.
Telephone advice may be given over the telephone instead of an outpatient appointment and may be supported by a written letter to you and your GP.
We hope that this enhances and promotes your ability to care for yourself once treatment has been completed and enables you to benefit from the team’s expertise as required.
Life after treatment, health and well-being
Diet and exercise
Eating a balanced diet is one of the best choices you can make for your overall health. Being overweight and not eating enough fruit and vegetables could increase your risk of cancer. Thinking about what and how much alcohol you drink is part of this too.
Keeping to a healthy weight will help you maintain or regain your strength, ease treatment side effects and have more energy.
Regular exercise is also important. Exercise can reduce the risk of cancer coming back if you’ve been diagnosed, as well as reducing the risk of developing cancer if you’ve never been diagnosed.
Making changes to your diet is not always easy. It may be more difficult if you are coping with a cancer diagnosis and having treatment. You could make changes gradually so that it is easier to eat differently.
Many people find making this positive choice helps give them back a sense of control. It can also help you feel that you’re doing the best for your health.
Local support services
Please contact your nurse if you have any questions or concerns or are worried about something to do with your cancer and the treatment that you have had for.
We would rather see you with something that turns out to be nothing, than for you to be at home worrying.
Macmillan cancer information and support service
- James Cook Hospital, Middlesbrough, Telephone: 01642 855674
- Sir Robert Ogden Macmillan Centre, Northallerton, Telephone: 01609 764033
- Email: [email protected]
- Monday to Friday – 9am to 4pm (closed bank holidays). Times may vary depending on the service.
Macmillan cancer support
- Telephone: 0808 808 0000
- Monday to Friday, 9am to 8pm
- Visit the Macmillan cancer support website: www.macmillan.org.uk
Ova the Rainbow gynaecological cancer support group
- Telephone: 01642 282418
- First Tuesday of every month at The Allerton Court Hotel, Northallerton, DL6 2XF
2pm to 3.30pm - Third Thursday of every month at The Roundel, Thornaby, TS17 9AE
11am to 12.30pm
Womb cancer information and support
- Visit the peaches womb cancer trust website: www.peachestrust.org/
Information and support for cervical cancer
- Visit the Jo’s cervical cancer trust website: www.jostrust.org.uk
Target ovarian cancer
- Support line: 020 7923 5475
- Visit the target ovarian cancer website: www.targetovariancancer.org.uk
Ovarian cancer support – Ovacome
- Visit the ovacome ovarian cancer website: www.ovacome.org.uk
Fighting women’s cancer
- Visit the eve appeal website: www.eveappeal.org.uk
Premature menopause and related issues
- Visit the daisy network website: www.daisynetwork.org
Specialist charity for sex and relationship therapy
- List of qualified practitioners and clinics providing therapy www.cosrt.org.uk
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]