Cancer Services at WNHS
The Western Australian Gynaecologic Cancer Service (WAGCS) is the state-wide cancer service for women at risk of or with a gynaecologic cancer diagnosis.
If you have been referred to the WAGCS you are likely to be feeling worried about the problem you have been referred with, and what may be required for your treatment.
There are no simple answers to address your concern, but we hope the information provide below helps you and your family understand your journey that lay ahead.
How is a gynaecologic cancer diagnosed?
If the area of your body where the possible cancer is situated is easily accessible a sample of cells from the skin surface, by fine needle aspiration or taking a fluid sample for cytology may be taken. This can help greatly in establishing your diagnosis.
Where the possible cancer is deeper in the body a radiologist may need to use an ultrasound or CT scan to guide them in taking the biopsy. Otherwise surgery may be required with the aim to completely remove the abnormal tissue.
Once accessibly a pathologist examines the cells under a microscope to arrive at a diagnosis. Sometimes additional tests are required, and further opinion is sought when the diagnosis is not immediately obvious.
This can take additional time but it is important to arrive at the correct diagnosis as treatment for different cancers do differ significantly.
What happens to your referral?
Once your referral is received it will be ‘effectively prioritised’ based on the information provided by your GP. In hospital terms we call this being ‘triaged’.
Generally, referrals are triaged as:
- Category 1 to be seen within 30 days (URGENT),
- Category 2 to be seen between 30 to 90 days (semi urgent)
- Category 3 to be seen within 12 months (non urgent).
Before you attend the clinic, we may organise for you to have some additional tests that will help guide your consultation. Where possible, your case and test results are then discussed at our weekly Multidisciplinary Care meeting which means all the health professionals involved in your care journey attend.
This ensures that opinions from the experts have been considered when you attend your appointment.
What if there is a delay?
We understand that delays in your journey from diagnosis to treatment can be unsettling but getting all the available information, confirming the diagnosis, seeing and assessing you, and arranging your treatment all takes time. We want to make sure we are providing you with the correct and best suited treatment for your diagnosis.
Our commitment to aspire to meeting the Comprehensive Care standard means we will do what we can to ensure you get the best care in an appropriate place by the most qualified people – so rest assured.
Sometimes we find something unexpected, and this leads to further delays.
Sometimes we are dependent on other hospital or care providers outside King Edward Memorial Hospital to be involved in your care. We don’t have control over those appointments, but know we are always advocating for you.
Should you find your journey is not what you expect, please let us know so that we can advocate on your behalf.
What happens at my appointment?
If you have been referred to our clinics, please visit Your Clinic Appointment section of our website for handy information on parking, what to bring and assistance animals. We also have a creche available for children whilst you attend your appointment.
At your appointment, you will be greeted by the clerical staff, and seen by the nurses and doctors. If required, members of our allied health team (physio, dietitian and or occupational therapist) will also see you. Sometimes you may require additional tests or referrals your health care team will discuss this with you at your appointment.
How are gynaecologic cancers treated?
Specific cancer treatment depends on which organ the cancer has arisen (primary site), the type of cancer (histopathology and grade), the spread (stage), if it is a recurrence, your general health, and your goals of care. The type of treatment available to you would be suggested after gathering all of the above information.
Treatment may include any of the following;
- surgery
- radiation
- chemotherapy including immunotherapy
- molecular therapy
- hormones and
- supportive therapy.
What if I need surgery?
If surgery is recommended (PDF), the required paperwork will be completed after a full discussion with you, and arrangements will be made for you to be assessed in relation to the surgery at our preadmission clinic.
Sometimes the surgery will need to be organised at another hospital so that additional resources not available at King Edward Memorial Hospital can be accessed.
Your healthcare team will be advocating for you to access required surgery at the earliest available opportunity. However, the logistics of organising surgery at other hospitals is complex and depends on many different unpredictable factors.
What if I need to attend a different hospital?
New appointments to see the Radiation or Medical Oncologist (external site) are made by their respective teams who are not based at King Edward Memorial Hospital. They will therefore make your appointment once they receive your referral and get in contact with you.
As the Radiation and Medical Oncologists attend the Multidisciplinary Care meeting, they know your case and the treatment plan – so your care should transfer seamlessly and with ease.
Sometimes you may be offered participation in a clinical trial because of your specific situation. This will be discussed with you at your appointment.
Why is a multidisciplinary team required?
The team who help in making the diagnosis include your family doctor and specialist, radiologist and pathologist, hospital doctors, cancer nurses, the clerical and administrative staff. Together we gather great expertise.
The team involved in providing the cancer care may include a gynaecologic oncologist (surgery), radiation oncologist (radiation therapy), medical oncologist (chemotherapy, immunotherapy, molecular therapies), radiologist (CT and MRI), pathologist (to examine tissues), palliative physician (supportive care), anaesthetist, physician, cardiologist, geneticist, other surgeons, psychiatrist and your family doctor.
Where do my team of health professionals work?
The multidisciplinary teamwork starts with your referring doctor. By the time you are referred to the WAGCS, you may already have gone from your referring doctor to a laboratory for blood tests, a radiology clinic for a CT scan or ultrasound, or had a biopsy taken for pathology.
In your individual case, you may be required to access some of your care at other clinics or hospitals outside King Edward Memorial Hospital.
Radiation therapy and chemotherapy are not available at King Edward Memorial Hospital.
A dedicated team
The WAGCS is made up of people who are committed to doing the best for you. We know this will be an anxious time for you and your family.
If you do not live close to King Edward Memorial Hospital, and you find navigating the various appointments challenging, we can help through our Cancer Nurse Coordinators (external site) or through the Cancer Council (external site).
We will do what we can to ensure your experience is positive and your outcome is the best possible.
If you have a positive experience or would like to let us know how we could do better, we would appreciate your feedback.