An individualised clinical assessment is required to meet the identified needs of the woman, her carer and family; referral should be as required.

In addition to common issues identified in the Appendix, specific needs that may arise at this time include:

• treatment for physical symptoms such as pain and fatigue
• help with the emotional distress of dealing with a potential cancer diagnosis, anxiety/depression (particularly about potential loss of fertility), interpersonal problems, stress and adjustment difficulties
• referral to a fertility service for counselling and evaluation of options
• guidance about financial and employment issues (such as loss of income, travel and accommodation requirements for rural women and caring arrangements for other family members)
• appropriate information for women from culturally and linguistically diverse backgrounds.

Effective communication is essential at every step of the care pathway. Effective communication with the woman and her carer is particularly important given the prevalence of low health literacy in Australia (estimated at 60 per cent of Australian adults) (ACSQHC 2013).

The general or primary medical practitioner who made the referral is responsible for the woman until care is passed to another practitioner.

The general or primary medical practitioner may play a number of roles in all stages of the cancer pathway including diagnosis, referral, treatment, coordination and continuity of care as well as providing information and support to the woman and her family.

The general or primary practitioner should:

• provide the woman with information that clearly describes who they are being referred to, the reason for referral and the expected timeframe for appointments
• support the woman while waiting for the specialist appointment.

Cancer Council nurses are available to act as a point of information and reassurance during the anxiety-provoking period of awaiting further diagnostic information. Contact 13 11 20 nationally to speak to a cancer nurse. Health professionals can also access this service.