Abstract
Endometrial cancer is the most common gynaecological cancer in Australia and its incidence is rising. Current follow up requires women to return to tertiary hospitals for five years after definitive surgery. However there is little evidence that recurrent disease is detected at these visits and does not address co morbid conditions.
Objective
The aim of the project was to implement and evaluate a model of follow up care for women following definitive surgery for early endometrial cancer led by specialist gynaecological oncology nurses. The woman’s health, psychosocial, emotional and cancer related needs assessment is completed and appropriate referrals are made and clinical outcomes are handed over to the woman’s general practitioner.
Method
Grant funding was sought from the Integrated Cancer Services supporting a multidisciplinary team. Evaluation measures included both quantitative and qualitative components including; recruitment to the model of care, surveys of women and general practitioners, medical record review, communication to general practitioners, service data, review of pre cohort medical records and service data and integration into standard practice.
Results
The results of the pre cohort review revealed minimal referrals to supportive services and few indications that co morbid conditions were addressed. Post clinic surveys indicated that the model was acceptable to women, general practitioners and cancer specialists and that previously unmet needs were being addressed. The new model has been accepted as standard of care at the Royal Women’s Hospital and is being explored as a potential survivorship model in other settings.
Discussion
As increasing numbers of people are surviving a cancer diagnosis, in order to address holistic health needs and maintain capacity in tertiary centres it is likely that general practitioners will be required to provide follow up care. Our model demonstrates an option that is both acceptable and of high quality.