FOI Ref: 0134FOI1920 

8th November 2019

Freedom of Information Act 2000 - Request for Information

We are pleased to respond to your request for information and our response is set out below:  

Request/ Response

I am writing with a Freedom of Information request to South Yorkshire, Bassetlaw and North Derbyshire Cancer Alliance.

To give some context to the FOI questions below, we at [redacted] are undertaking some research into specialist service provision for people suffering from pelvic radiation disease following cervical cancer treatment.  In 2017 we published a report, 'Long Term Consequences of Cervical Cancer and It's Treatment' which found that 88% of women have experienced at least one, 63% at least three and 24% at least six physical long term consequences of their cervical cancer treatment. Only half of women who have experienced bowel and urinary problems had received treatment (41% and 54% respectively).

We would be grateful if you could answer the below questions so we can build a picture of the referral protocols that are being used, and the availability of services across the country. 

Thank you.

1. In your Cancer Alliance area, do you have specialist clinics for patients who have had treatment for cervical cancer and are experiencing the late effects of pelvic radiotherapy, e.g. bowel or urinary issues (also known as pelvic radiation disease or PRD)

a. If so, please give details of:

i. The clinic(s) name and opening times

ii. Annual caseload

iii. The proportion of patients referred direct from oncology

iv. The proportion of patients referred from their GP

We do not have a specific clinic for patients who have had treatment for cervical cancer and are experiencing the late effects of pelvic radiotherapy but we do have a well-established late effects service which does offer support and onward referral to appropriate specialists and services if further diagnostics or treatment is required.

2. Does your oncology team have a standardised method of identifying people with PRD for referral (e.g. by asking patients the questions in the ALERT-B tool to support the clinical assessment of patients suitable for referral to a gastroenterologist)?

We are not using the Alert B tool but the information is recorded in patients clinic review letter - the questions asked of the patient are similar to that in the Alert B tool.  

3. Does your radiotherapy centre ensure patients are aware of possible acute and long-term side effects of pelvic radiotherapy before they undergo treatment? If so, how?

Yes. Patients are supported at the time of their diagnosis and offer of radiotherapy treatment by their key worker. At the consultation they are provided with numerous information sources but typically we issue our guidance information leaflets, which supplement the information that we provide to patients at the time of consent, where the acute and late side-effects are explained.  

3. Does your radiotherapy centre offer a range of materials to support with acute or late effects of radiotherapy, e.g. booklets, symptom checklist, toilet cards? If so, what materials do you provide?

Yes. Patients are seen by a specialist Gynae radiographer (who concentrates in particular on long term vaginal issues).

4. Do your gastroenterologists and dieticians use the PRD bowel algorithm, published in 'The Practical Management of the Gastrointestinal Symptoms of Pelvic Radiation Disease'? https://www.macmillan.org.uk/_images/practical-management-gisymptoms-pelvic-radiation-disease_tcm9-300557.pdf

You will need to contact the provider for this information, see contact details overleaf.  

Please note that the responses we have given were provided with help from Sheffield Teaching Hospitals NHS Foundation Trust (STH), if you require any further detail, please contact STH directly (foi@sth.nhs.uk).