Appointment sheet
Early cervical cancer and fertility-sparing surgery
Prepared with OnCo (onco.cc/prep/early-cervical-cancer/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
18 on the sheetNewly diagnosed
- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example FIGO 2018 stage from clinical examination, MRI and PET-CT, Tumour size and depth of stromal invasion, Lymphovascular space invasion, Sentinel or pelvic node status, HPV type and p16), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
Stage IA1 without lymphovascular invasion
- 5.For my situation (stage ia1 without lymphovascular invasion), which of the standard options do you recommend and why?
Stage IA2 to IB1 up to 2 cm, low risk
- 6.For my situation (stage ia2 to ib1 up to 2 cm, low risk), which of the standard options do you recommend and why?
- 7.How do the results of SENTICOL III apply to someone like me?
Stage IB1 to IB2, standard
- 8.For my situation (stage ib1 to ib2, standard), which of the standard options do you recommend and why?
- 9.How do the results of LACC (Laparoscopic Approach to Cervical Cancer) apply to someone like me?
Fertility preservation
- 10.For my situation (fertility preservation), which of the standard options do you recommend and why?
Adjuvant after surgery
- 11.For my situation (adjuvant after surgery), which of the standard options do you recommend and why?
- 12.Am I a candidate for Cisplatin, and what side effects should I expect?
Prevention and detection
- 13.For my situation (prevention and detection), which of the standard options do you recommend and why?
Any stage
- 14.Are there clinical trials I could join, for example of SENTICOL III, HPV DNA testing and self-sampling, HPV & HBV vaccination, HPV circulating tumour DNA to guide cervical cancer therapy?
- 15.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 16.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 17.I read that “Whether sentinel node biopsy alone can replace lymphadenectomy (SENTICOL III)”. How does that affect my plan?
- 18.I read that “Safe fertility-sparing options for tumours of two to four centimetres”. How does that affect my plan?
The words I may hear
- Minimally invasive surgery (laparoscopic, robotic, VATS): Any operation done through small incisions with cameras and long instruments, including robot-assisted surgery; the cancer operation is the same, the wound is smaller.
- HPV status (HPV-positive / HPV-negative): Whether a cancer is caused by human papillomavirus.
- Hysterectomy: Removing the uterus (womb), often with the cervix, tubes and ovaries.
- Chemoradiation (chemoradiotherapy, CRT): Radiotherapy given at the same time as chemotherapy, which sensitises the cancer to radiation.
Tests and results to bring
Biomarker results to ask for: FIGO 2018 stage from clinical examination, MRI and PET-CT, Tumour size and depth of stromal invasion, Lymphovascular space invasion, Sentinel or pelvic node status, HPV type and p16 (HPV-associated versus independent), Margin and parametrial status after surgery.
Scans and tests linked to this cancer: Colposcopy and excisional treatment (LEEP/LLETZ, cone), HPV DNA testing and self-sampling, MRI, MRD / molecular residual disease testing.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Prevention and detection: HPV vaccination and HPV-based screening with colposcopy for positives. (HPV & HBV vaccination, HPV DNA testing and self-sampling, Colposcopy and excisional treatment (LEEP/LLETZ, cone), HPV status (HPV-positive / HPV-negative))
- Stage IA2 to IB1 up to 2 cm, low risk: Simple hysterectomy with node assessment (SHAPE) or open radical hysterectomy; sentinel node biopsy where a trial or protocol supports it. (Hysterectomy, Sentinel lymph node biopsy, SENTICOL III, MRI)
- Adjuvant after surgery: Pelvic radiotherapy for intermediate-risk features; cisplatin chemoradiation for positive nodes, margins or parametria. (IMRT / IGRT (modern external beam), Cisplatin, Brachytherapy, Chemoradiation (chemoradiotherapy, CRT))
- Stage IA1 without lymphovascular invasion: Cone biopsy with clear margins or simple hysterectomy; no node assessment needed. (Colposcopy and excisional treatment (LEEP/LLETZ, cone), Hysterectomy)
- Stage IB1 to IB2, standard: Open radical hysterectomy with pelvic lymphadenectomy; minimally invasive radical hysterectomy avoided after LACC. (LACC (Laparoscopic Approach to Cervical Cancer), Caution: minimally invasive radical hysterectomy for early cervical cancer, Robotic & minimally invasive surgery, Minimally invasive surgery (laparoscopic, robotic, VATS))
- Fertility preservation: Cone or simple trachelectomy for IA disease; radical trachelectomy with node assessment for IB1 tumours up to 2 cm. (Colposcopy and excisional treatment (LEEP/LLETZ, cone), Sentinel lymph node biopsy, MRI)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call