Newly Diagnosed

Are you newly diagnosed with cancer?

Here's what you need to know:

Know your exact diagnosis and stage of disease.

Gather the facts and write them down in a notebook.  Ask questions like:

  • What is the exact name of my cancer?
  • What is the stage of my cancer?
  • Is there anything we know or can learn about my disease that will help guide.
  • My treatment decisions such a biomarker or genetic test?

Write down your questions and concerns in advance.

It can be difficult going to your doctor/specialist to hear a diagnosis or to get updates on what's going on.


Appointments

The following are tips for you:

  • Make a list of questions before going to your appointment.
  • Take a support person with you; this is important as you don't always take everything in and it's difficult to remember everything the medical professional is telling you.  
  • Take notes or have your support person take them for you.  You can refer back to these later.
  • Make sure you understand everything your medical professional tells you before you leave.
  • Ask questions.

Tests

In addition to a physical examination, the followings tests may be used:

  • Pelvic examination - The doctor examines the vagina, the rest of the reproductive tract, bladder and rectum to check for any unusual changes.

  • Pap Smear - During a Pap Smear, the doctor gently scrapes the outside of the cervix and vagina and takes a sample of cells for testing.  During the test, a woman will usually feel some pressure as the doctor takes the sample of the cells, but there is usually no pain.  HPV testing is usually part of the Pap Smear in women who are older than 30

  • Colposcopy - The doctor may do a colposcopy to check the vagina and cervix for any abnormalities, especially when Pap Smear or HPV test has returned abnormal results.  A colposcope is a special instrument, similar to a microscope, that magnifies the surface of the cervix and vagina. 

    The colposcope gives the doctor a lighted, magnified view of the tissues of the vagina and the cervix.  The colposcope is not inserted into the woman's body.  The examination is not painful, can be done in the doctor's office, and has no side effects.  This examination can be performed on pregnant women.

  • Biopsy - A biopsy is the removal of a small amount of tissue for examination under a microscope.  Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis.  A pathologist analyses the sample(s). 

    A pathologist is a doctor who specialises in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.  The type of biopsy performed will depend on the location of the tissue being biopsied.

  • Ultrasound - An ultrasound uses sound waves to create a picture of the internal organs.

  • Endoscopy - an endoscopy allows the doctor to see inside the body with a thin lighted, flexible tube called an endoscope.  The person may be sedated as the tube is inserted through the mouth, anus, vagina, urethra, or a small surgical opening.  Sedation is giving medication to become more relaxed, calm or sleepy.

  • CT or CAT Scan (Computed Tomography) - a CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles.  A computer combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. 

    A CT scan can be used to measure the tumor's size.  Sometimes, a special dye called a contrast medium is given before the scan to provide better detail in the image.  This dye can be injected into a patient's vein orally.

  • MRI (Magnetic Resonance Imaging) - An MRI uses magnetic fields, not x-rays to produce detailed images of the body.  A special dye called a contract medium is given before the scan to create a clearer picture.  This dye can be injected into a patient's vein or taken orally.

  • PET or PET-CT Scan (Positron Emission Tomography) - A PET scan is usually combined with a CT scan, called a PET-CT scan.  However, you may hear your doctor refer to this procedure just as a PET scan.  A PET scan is a way to create pictures of organs and tissues inside the body.  A small amount of a radioactive sugar substance is injected into the patient's body.  This sugar substance is taken up by cells that use the most energy.  Because cancer tends to use energy actively, it absorbs more of the radioactive substance.  A scanner then detects this substance to produce images of the inside of the body.

    Medical Team

    Once you are diagnosed your health will be managed by a medical team of health care professions.  These may include:

    • Clinical Nurse Specialist: Health professionals who are a significant and valuable member of the multidisciplinary team.  They have an important role as point of contact for patients, providing emotional/practical support and referring to other support agencies as necessary, acting as advocate ate, providing information and teaching, expediting appointments/investigations etc. 
    • Dietitian: A health professional who specialises in nutrition and gives people advice on how to eat well to help them recover from cancer.

    • Genetic Counselor:  A health-care professional providing a critical service to individuals and families considering undergoing genetic testing by helping them identify their risks for certain disorders.

    • Gynaecological Oncologist: A doctor who specialises in treating cancers of the female reproductive organs. The training to become a gynaecological oncologist is first that of an obstetrician / gynaecologist, followed by 2-4 years of training in all effective forms of treatment of gynaecological cancers and experimental treatments, as well as in the biology and pathology of gynaecological cancers. Gynaecological oncologists are expert surgeons.

    • Gynaecological Physiotherapist: Provides specialised care for gynaecological patients.  They work with consultants to help treat many pelvic floor disorders including bladder/bowel dysfunction, incontinence, prolapse, sexual pain, chronic pelvic pain and constipation.

    • Haematologist: A doctor who specialises in treating blood disorders.

    • Lymphoedema Physiotherapist: Provides a specialised field of physiotherapy using the principles of massage, skin care, exercise and compression to aim to reduce or control the swelling, improve the range of movement and prevent infection.

    • MDM Meetings: A Multidisciplinary Team; several members of different hospital departments who meet to discuss the treatment plan for individual patients.

    • Oncologist: A doctor who specialises in treating cancer and caring for people who have cancer.

    • Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope.  A gynaecological pathologist will look at samples of tissue taken from surgery (biopsies) under a microscope to look for cancer, and determine what type of cancer you have.

    • Radiographer:  A member of the health-care team who takes and analyses X-rays and scans.

    • Radiologist: A specialist doctor who uses X-rays, scans and other images to treat a disease.

    • Radiotherapist:  The member of the health-care team who gives patients radiotherapy.

    Radiation Therapy

    Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells.  A doctor who specialises in giving radiation therapy to treat cancer is called a radiation oncologist.  Radiation therapy may be used alone or after surgery.  The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. 

    A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. 

    One method is intracavity radiation therapy, in which tiny tubes of a radioactive substance are placed in the vagina for 1 to 2 days.  Patients must stay in bed during this time.  This type of procedure is very useful for treating vaginal cancers and is often used with external-beam radiation therapy. 

    Another method is interstitial radiation therapy, in which radioactive materials is injected directly into the tumour. Side effects from radiation therapy depend on the dose used, the area targeted, and the type of radiation therapy. 

    Side effects may include fatigue, mild skin reactions, upset stomach, and loose bowel movements.  Most of these side effects go away soon after treatment is finished.  Other side effects may include the narrowing of the vagina, damage to healthy vaginal tissue, dryness of the vagina, and irritation of the intestines.

    Chemotherapy

    Chemotherapy is given to reduce any disease that remains after surgery, or to reduce the likelihood of the cancer returning. Chemotherapy works by attacking cells that divide rapidly. If your cancer has been discovered at an early stage you may not require chemotherapy. However, most patients need to have some chemotherapy and this is usually started after surgery.

    In some cases, chemotherapy is given first and surgery is carried out afterwards. Chemotherapy drugs are usually given by mouth or injected into a vein which enables them to enter the bloodstream in order to kill cancer cells. It’s usually given in cycles of treatment followed by a rest period that allows normal cells to recover from the effect of the drugs.

    A typical course of chemotherapy for ovarian cancer involves six cycles. Each cycle lasts three or four weeks. When you’ve finished chemotherapy, you will have check-ups every three months, and then every six months if you’re still cancer free. If you are cancer free after ten years (or five years for early stage ovarian cancer), you’ll be considered to be in remission and you’ll no longer need regular check-ups.  

    Side effects of chemotherapy

    Chemotherapy drugs are very powerful and they can affect some normal cells. The cells that are typically affected include hair follicles, the cells that line your stomach and intestines, red and white blood cells, and blood clotting agents. 

    Symptoms you might experience include:

    • nausea and vomiting
    • a loss of appetite
    • extreme tiredness
    • a sore mouth and,
    • with certain types of chemotherapy, hair loss.
    Side effects experienced will vary from person to person, and will depend on how much of a drug you are given and how long your treatment lasts. It may also just depend on how your body reacts generally to the treatment.


      If you experience side effects during your treatment be sure to discuss them with your clinical oncology team as they will be able help you manage them.

      Telling your family and friends

      Telling your family and friends that you have ovarian cancer can be difficult and you may feel worried about how they will react. There’s no right or wrong way to let your family and friends know, but following these tips might help:
      • Choose a quiet location – a comfortable, quiet and private place will help you to focus on what you’re saying.
      • You don’t have to do it alone – you may find it easier to have someone with you while you tell other people, or you may prefer someone else to tell your friends and family for you.
      • Little by little – introducing the subject gradually will give people time to prepare for what they’re about to hear. Telling people suddenly can sometimes cause more distress.
      • Keep it brief – talking about key facts will help your friends and family process what they’re hearing.
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