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Services
Offered
Postmenopausal
Bleeding (PMB)
Pelvic
Masses and Ovarian Cysts
Abnormal
Smears, Postcoital Bleeding
Suspicious Cervix and Vulva
Treatment
of Cancer
Care
of the Woman who has, or might have Cancer
Who
sees me?
Postmenopausal
Bleeding (PMB)
PMB may indicate endometrial
abnormalities including endometrial cancer. Fortunately most
women with PMB will not have cancer, but it is important that
all women with PMB are properly assessed. In the first instance
the lower genital tract should be carefully examined. Assuming
this is normal, a transvaginal ultrasound scan (TV USS) should
be performed to assess the thickness and regularity of the
endometrium and to check the ovaries. If the scan is normal,
then usually the woman does not need any further investigation
and can be reassured. If the scan appearances of the endometrium
are abnormal, or if the PMB is recurrent, or if the woman
has been on tamoxifen, then the woman will probably need a
hysteroscopy and endometrial biopsy. This can almost always
be performed as an outpatient procedure under local anaesthetic.
Our modern equipment also allows the removal and treatment
of the underlying cause (eg polyps) in outpatients using Versapoint
technology.
Pelvic Masses and Ovarian Cysts
In any woman with a
pelvic mass cancer must be excluded. Fortunately most masses
turn out to be benign. The diagnosis is usually made using
ultrasound or other imaging (such as CT or MRI), together
with a blood test (CA 125). Based on these results a management
plan can be made: this can range from reassurance, or repeating
the scan in a couple of months’ time, through to surgery
(including laparoscopic).
Abnormal Smears, Postcoital Bleeding
Suspicious Cervix and Vulva
When a woman has an
abnormal smear, unless it is a very mild abnormality, a colposcopy
is needed to inspect the cervix and to guide treatment. Biopsies
are usually taken, and if treatment is required, this can
almost always be performed under local anaesthetic. Suspicious
lesions of the cervix and of the vulva can be assessed in
the same way. Our service is provided by accredited colposcopists,
who undergo continual professional assessment to provide quality
assurance.
Treatment of
Cancer
All gynaecological
cancers in the Cambridge network are discussed at a weekly
multidisciplinary meeting at Addenbrooke’s, including
NHS and private patients. This allows an expert recommendation
to be made to the patient about her treatment options. Surgery
is often one of these options. This surgery is performed by
trained Gynaecological Oncologists who have received accredited
advanced training in gynaecological cancer management. Practitioners
are also accredited in advanced laparoscopic surgery and can
offer the full range of surgical procedures that may be necessary.
In particular, the multidisciplinary team environment ensures
appropriateness of decision making, helping to avoid over-
or under- treatment.
Care of the Woman who has, or might have Cancer
When anyone is concerned
about cancer it is a very frightening experience. Timely and
expert assessment and treatment are vital. However, just as
important is for the woman to be at the centre of what is
going on, being kept informed and being closely involved in
all the decision-making. She must be valued and respected
as an individual with her own beliefs, and her own fears and
hopes.
Who sees me?
A referral is usually
needed from the general practitioner, and can be faxed. You
may be asked to attend for an ultrasound and a blood test
before seeing the Gynaecological Oncologist. The service is
provided by a group of specialists who all work in the Gynaecological
Cancer Centre at Addenbrooke’s Hospital Cambridge.
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