Gynaecological cancers arising in the female reproductive system include:
They account for 12% of female cancers in the U.K. (2013)
Multi-disciplinary team working and specialist referral has improved the management of women with gynaecological cancer in the U.K. Kingston Hospital NHS Foundation Trust works closely with its partner cancer centre The Royal Marsden Hospital. Kingston Hospital offers a comprehensive assessment and diagnostic service. Patients will be seen at Kingston Hospital by a consultant gynaecologist who is a specialist in the management of gynaecological cancer, who will arrange the appropriate diagnostic tests, and will inform patients of their diagnosis and treatment plan.
Through the NHS Cervical Screening Programme, women are screened for pre-malignant changes to the cervix (Cervical Intra-epithelial Neoplasia: CIN). Human papillomavirus (HPV) testing has also been introduced as part of the National Screening Programme. If a smear test indicates abnormalities, and a woman has a positive HPV test she will be referred to the Colposcopy Clinic at Kingston Hospital.
At the Colposcopy clinic, a specialist nurse or doctor will use a colposcope (special microscope) to view changes to the cervix at high magnification and a biopsy may be taken. Treatment- a large loop excision of the transformation zone (LLETZ), which removes abnormal cells from the cervix is usually undertaken in the out-patient department. Follow –up involves a repeat smear at 6 months, usually at your GP surgery and an HPV test is included as part of this screening test.
Cervical cancer (cancer of the neck of the womb) is diagnosed though a biopsy of the cervix The most common cervical cancers are Squamous cell (80%) and Adenocarcinoma (15-20%). Patients will be seen by a Consultant Gynaecologist who specialises in gynaecological cancer, and may have their condition assessed by a specialist MRI scan undertaken at The Royal Marsden Hospital. Other investigations may involve ultra sound or CT scans. Management of early micro- invasive disease may be undertaken at Kingston Hospital otherwise patients are referred for treatment to The Royal Marsden Hospital. Treatment may comprise of surgery, radiotherapy and chemotherapy.
Patients with suspected endometrialcancer (cancer of the lining of the womb) will be assessed by a consultant gynaecologist who specialises in gynaecological cancer, and will undergo diagnostic tests, including trans-vaginal ultrasound scan, out-patient biopsy and hysteroscopy. Women with a diagnosis of endometrial cancer will have CT and MRI scans to assess the extent of the tumour. Women with early stage cancer may be treated surgically at Kingston Hospital. Other patients will be referred for specialist management at The Royal Marsden Hospital, which may include surgery, radiotherapy and chemotherapy.
Patients with suspected ovariancancer are assessed at Kingston Hospital by a consultant gynaecologist specialising in gynaecological cancer and through a combination of ultra sound examination, CA- 125 blood test, and CT scan. An ultra sound or CT guided biopsy may also be done for diagnosis. Patients are then referred for their treatment to The Royal Marsden Hospital and this may include surgery and chemotherapy.
Women with the less common gynaecological cancers such as vulval and vaginalcancer will be seen by a specialist consultant at Kingston Hospital, and undergo biopsy to confirm the diagnosis of cancer and MRI or CT scans to assess the extent of the disease. Following diagnosis these patients will usually be referred to The Royal Marsden Hospital for treatment which may include surgery, radiotherapy or chemotherapy.
At Kingston Hospital we have a specialist Gynaecological Cancer follow up clinic that is undertaken by a consultant gynaecologist who specialises in gynaecological cancer and a clinical oncologist from The Royal Marsden Hospital, so patients may be followed up locally.
Our links with our partner cancer centre The Royal Marsden Hospital ensures that women receive the highest standard of care.
What is a Holistic Needs Assessment ( HNA)
People with cancer often require care, support and information in addition to the management of their cancer or condition.
A holistic needs assessment is a discussion with your doctor or nurse to talk about your physical, emotional and social needs. The focus is on you as a whole – not just your illness. Your doctor or nurse will need information from you. However, you decide how much information you would like to share about your current situation. This is an opportunity for you to talk about any worries or concerns you may have. It will help to clarify your needs and ensure that you are referred to the relevant services.
In order to prepare for this discussion, you may be asked to complete a questionnaire to bring to your next consultation.
This is not compulsory and not having this assessment will not affect your care. However, many patients find having an assessment helpful as it can help to identify what help is available.
It may be offered at certain times during your care, including:
It may be carried out over the phone.
With your agreement the doctor or nurse carrying out your assessment may refer you to other services that may be of help to you. Alternatively, if you prefer, you will be given written information about these services.
The Gynaecological Cancer Team at Kingston is a specialist team which includes representatives of each part of the service that a patient will be involved with during their diagnosis and treatment. This includes: