Survivorship review — assessment and shared-care station

Assessment and shared-care station on gynaecological cancer survivorship: applying the symptom-driven surveillance principle, working up the swollen leg to exclude recurrence before diagnosing lymphoedema, managing sexual dysfunction and treatment-induced menopause, distinguishing adjustment from clinically significant fear of recurrence with the FORT trial, and producing a written survivorship care plan. Includes assessor key and marking domains.

Prompt

A 54-year-old woman, para 2, is 18 months out from total hysterectomy, BSO and sentinel lymph node biopsy for stage IB2 grade 2 endometrioid endometrial cancer, now under shared care with her GP. She presents to your general gynaecology clinic for a survivorship review reporting a swollen right leg, dyspareunia with vaginal dryness, hot flushes, and intrusive thoughts about recurrence affecting her sleep and work. You are the gynaecology registrar; the consultant is available.

Station brief

Format. Assessment and shared-care station, approximately 12 minutes. You are the gynaecology registrar. The assessor feeds examination findings and results as you go. [1]

Candidate instruction. Take a structured survivorship history, screen for the four late-effect clusters, work up the swollen leg to exclude recurrence, address the sexual dysfunction and menopausal symptoms, recognise clinically significant fear of recurrence, and produce a written survivorship care plan for the shared-care transition. [1]

Obstetrics & Gynaecology Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Obstetrics & Gynaecology fellowship atlas.

References4Show ledger

[1]Salani R, Khanna N, Frimer M, et al. An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology (SGO) recommendations. Gynecol Oncol, 2017.PMID 28372871
[2]Woopen H, Sehouli J, Davis A, et al. GCIG-Consensus guideline for Long-term survivorship in gynecologic Cancer: A position paper from the gynecologic cancer Intergroup (GCIG) symptom benefit committee. Cancer Treat Rev, 2022.PMID 35525106
[3]Maheu C, Lebel S, Bernstein LJ, et al. Fear of cancer recurrence therapy (FORT): A randomized controlled trial. Health Psychol, 2023.PMID 36862474
[4]Rizzuto I, Oehler MK, Lalondrelle S, et al. Sexual and Psychosexual Consequences of Treatment for Gynaecological Cancers. Clin Oncol (R Coll Radiol), 2021.PMID 34281725