Living Well and Survivorship

📝 KEY POINTS

  • Diagnosis understanding
  • Health literacy
  • Family history
  • Genetic testing
  • Treatment plan (consider concurrent treatments)
  • Treatment goals
  • Treatment adherence and compliance
  • Financial implications of treatment pathway
  • Oncofertility
  • Current treatment plan (consider concurrent treatments i.e. Chemo/ immunotherapy and noncancer treatments)
  • Out of pocket pharmaceutical costs
  • Taste change
  • Dental health / oral care
  • Safe sex and contraception
  • MDT meeting and involvement
  • Employment and financial assistance referrals
  • Exercise and physical activity
  • Social and emotional needs
  • Clinical trial considerations

🩺 TUMOUR SPECIFIC CONSIDERATIONS

Ovarian cancers (including fallopian tube & primary peritoneal cancers)

  • Consider referral for multidisciplinary prehabilitation, if service available
  • Assess for chemotherapy-induced peripheral neuropathy (CIPN)
  • Assess and monitor for ascites
  • Assess and provide information and care on bowel management (i.e. diarrhoea, constipation, monitor for bowel obstruction)
  • Assess for nausea and vomiting and potential risk for malnutrition
  • Assess emotional wellbeing, e.g. fear of recurrence
  • Assess need for a central venous access device (CVAD)
  • Refer to Ovarian Cancer Australia Teal Support Program

Uterine cancers (including endometrial cancer)

  • Chemotherapy may be recommended for palliative symptom control
  • Educate on potential impacts of concurrent chemotherapy and radiotherapy
  • Consider referral for multidisciplinary prehabilitation, if service available

Vulval cancer

  • Neoadjuvant treatment typically not used

☀️ LIVING WELL

  • Encourage ongoing GP contact for comorbid condition management, immunisation, screening, chronic disease, mental health care plan, and other health concerns
  • Offer health promotion and lifestyle maintenance solutions
  • Facilitate healthy lifestyle modifications
  • Facilitate advance care planning for patients aged over 75 years of age and support patient-directed advance care planning for patients aged under 75 years
  • Survivorship Care Plan

💬 DELIVERY CONSIDERATIONS

  • Need for interpreter services
  • Patient’s hearing status
  • Patient’s vision status

 

For Nurses
Points for MDT discussion
  • Advocate for patient preferences
  • Consider oncofertility needs
  • Consider clinical trials
  • Facilitate genetics referral (germline and somatic) prior to commencing, if appropriate
  • Consider CVAD
  • Consider goals of treatment (cure vs control, palliative)
Resources for nurses

Liaise with GP/cancer nurse/rural cancer nurse.

Assessment tools

 

For Patients
What is next for the patient? Who needs to know?
  • Communicate with patient and/or carer, family re: date to commence neoadjuvant treatment, orientation to treatment centre, patient education for treatment protocol
  • Facilitate appointment with gynaecological oncologist before/during neoadjuvant treatment
  • Discuss timing of restaging scans (CT, MRI, PET, CA125) and timing of follow-up appointment with local treatment centre post-surgery
  • MDT re-discussion after C3 to discuss suitability for interval debulking surgery
  • Communicate with GP
Common referrals
  • Allied health (dietitian, psychology, social work)
  • Exercise physiology
  • Stoma nurse, if applicable
  • Lymphoedema specialist
  • Continence nurse
  • Ovarian Cancer Australia Teal Support Program
  • Rare Cancers Australia
Resources for patients