Outpatient visits
High priority
Your outpatient appointment may be a high priority if:
- You have cervical cancer and are experiencing issues such as abdominal symptoms, complications following surgery/radiotherapy or renal obstruction
- You are experiencing persistent severe bleeding from a pelvic or vaginal ulcerated tumour
- You have cervical cancer and are not producing urine or you have symptoms of deep vein thrombosis
- You have recently been diagnosed with cervical cancer but have not had surgery, and you require an outpatient appointment to stage your cancer. In these cases, blood tests and imaging will be undertaken at local clinics if possible
Medium priority
Your outpatient appointment may be a medium priority if:
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You have recently had surgery for cervical cancer and have not experienced any complications
- You have lived with cervical cancer for some time and are not experiencing any new symptoms or side effects. In these cases, outpatient appointments will be conducted via telephone
- You have advanced or recurrent cervical cancer and the purpose of your appointment is for a clinical and pelvic examination after palliative treatment. In these cases, the outpatient appointment can be postponed for up to 2 months
Low priority
Your outpatient appointment may be a low priority if:
- You have undergone surgery for early-stage cervical cancer and the purpose of your appointment is for a clinical and pelvic examination. In these cases, the outpatient appointment can be postponed for up to 6 months
- Your appointment is a routine survivorship visit
Imaging
High priority
Your appointment may be a high priority if:
- You need imaging to investigate cancer-related symptoms such as bowel perforation or peritonitis
- You are experiencing post-surgery complications such as bowel perforation or anastomotic leak
- You need imaging to investigate compression of the ureter or hydronephrosis
- You are experiencing neurological symptoms and need imaging to check if your cancer is affecting your nerve roots or spinal cord
- You are experiencing acute symptoms such as severe difficulty in swallowing or intestinal occlusion
- You need imaging to stage your cancer
Medium priority
Your appointment may be a medium priority if:
- You have previously received curative treatment for early-stage cervical cancer but your doctor thinks that your cancer may have returned
- You have advanced or recurrent cervical cancer and you are scheduled to have follow-up imaging (along with a clinical and pelvic examination) after palliative treatment. In these cases, the imaging appointment can be postponed for up to 2 months
- You are participating in a clinical trial and imaging assessments are required as part of the study protocol. If you are participating in a clinical trial, you should contact the trial co‑ordinator to confirm if the study protocol will be altered in terms of frequency of treatment, blood tests and imaging
Low priority
Your appointment may be a low priority if:
- Your appointment is a routine follow-up visit. In these cases, blood tests and imaging will be undertaken at local clinics if possible, and follow-up appointments will be conducted via telephone
Surgery
High priority
Your appointment may be a high priority if:
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You need surgery to relieve symptoms of cancer-related complications such as bowel perforation or peritonitis
- You have received radiotherapy to treat a recurrence of your cancer, and you need surgery for complications arising during/after the radiotherapy, such as bowel perforation or fistulae
- You need surgery to treat complications arising from a previous surgical procedure, such as bowel perforation or damage to the urethra
Medium priority
Your appointment may be a medium priority if:
- You have stage IA2 or IB1–IIA cervical cancer and are due to undergo a radical hysterectomy (with or without removal of your ovaries and fallopian tubes)
- You have stage IA cervical cancer and are due to undergo a trachelectomy (with or without sentinel lymph node dissection). In these cases, surgery can be postponed for up to 2 months
Low priority
Your appointment may be a low priority if:
- You are scheduled to have surgery to repair fistulae, but you are not currently experiencing any symptoms
- You are scheduled to undergo conisation for grade 3 cervical intraepithelial neoplasia
- You are scheduled to have surgery to remove a slow-growing recurrence of your cancer
- You are scheduled to undergo pelvic exenteration. In these cases, your surgery may be postponed until after the COVID-19 pandemic
Radiotherapy
High priority
Your appointment may be a high priority if:
- You have stage IB3 or IIA–IIB cervical cancer and are scheduled to receive pelvic external beam radiotherapy with chemotherapy
- You need radiotherapy to treat spinal cord compression, brain metastases or other serious metastases
Medium priority
Your appointment may be a medium priority if:
- You are scheduled to receive salvage radiotherapy to treat a localised recurrence of your cancer that is causing symptoms
Low priority
Your appointment may be a low priority if:
- You are scheduled to receive palliative radiotherapy to treat a recurrence of your cancer that cannot be removed by surgery and is not causing symptoms
Medical management of cervical cancer
High priority
Your appointment may be a high priority if:
- You are receiving treatment as part of a clinical trial
- You have stage IB3 or IIB–IVA cervical cancer and are scheduled to receive chemoradiotherapy
- You have stage IVB cervical cancer and are scheduled to receive first-line treatment with cisplatin/paclitaxel plus bevacizumab. If you are not suitable for cisplatin treatment, you may receive carboplatin/paclitaxel or topotecan/paclitaxel in combination with bevacizumab
- You have a first local recurrence more than 12 months after primary chemoradiotherapy and are scheduled to receive first-line treatment with cisplatin/paclitaxel plus bevacizumab. If you are not suitable for cisplatin treatment, you may receive carboplatin/paclitaxel or topotecan/paclitaxel in combination with bevacizumab
Medium priority
Your appointment may be a medium priority if:
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You are undergoing standard chemotherapy and are experiencing clinical benefit
Low priority
Your appointment may be a low priority if:
- You are scheduled to receive second-line treatment with chemotherapy. In these cases, treatment decisions will be based on clinical need, patient wishes and the availability of resources
Additional considerations for cervical cancer management
- Immunotherapy will only be used to treat cervical cancer as part of a clinical trial
- Decisions on treatment will be discussed within a multidisciplinary team, taking into account the overall health of the patient and the available resources, such as intensive care unit support following surgery
- Patients and their families should be fully informed about the risk/benefit ratio of each intervention
- Doctors should take into account any relevant national guidelines or recommendations relating to COVID-19