Establish intent of treatment

• Curative
• Anti-cancer therapy to improve quality of life and/or longevity without expectation of cure
• Symptom palliation

Treatment options

Except for early-stage and well-differentiated disease, women are usually treated with surgery and chemotherapy.

Surgery: Surgery may be used to stage the cancer, and as a form of therapy.

The type of surgery offered will depend on a number of factors: the stage of the disease; the age and performance status of the woman; and the desire or not to retain fertility.

Systemic therapy: Chemotherapy or drug therapy may be appropriate as neoadjuvant or adjuvant treatment, or as a primary treatment modality.

Radiation therapy: Some women may benefit from radiation therapy for symptomatic relief and palliation of metastatic or recurrent disease. In selected cases, it may also be considered as part of primary treatment.

Loss of fertility and/or premature menopause following treatment requires sensitive discussion.

Palliative care

Early referral to palliative care can improve quality of life and in some cases survival. Referral should be based on need, not prognosis. For more, visit the Palliative Care Australia website.

Communication

The lead clinician and team’s responsibilities include:

• discussing treatment options with the patient and/or carer including the intent of treatment as well as risks and benefits
• discussing advance care planning with the patient and/or carer where appropriate
• communicating the treatment plan to the patient’s GP
• helping patients to find appropriate support for exercise programs where appropriate to improve treatment outcomes.

Checklist

Timeframe

Surgery should be conducted within 4 weeks of the suspected or confirmed diagnosis and within 2 weeks of the MDM.

Neoadjuvant chemotherapy should start within 2 weeks of the MDM.

Adjuvant chemotherapy should start within 4 weeks of surgery.

Radiation therapy should start within 4 weeks of the MDM.