Confusing discharge letter

Hi all My relative was found to have cysts, masses and fibroids and has been offered full hysterectomy. Doctors did not tell them they have cancer but discharge letter states ‘likely ovarian cancer’ in one paragraph. The final page of the letter states, ‘conclusion: large ovarian cancer’. Doctors told my relative they’ll test the masses for cancer after the hysterectomy because they’re not sure. My question is, do they have cancer or not? and shouldn’t they have told them verbally than writing it down? Lastly, is it fair they’ve been discharged home to wait for hysterectomy in 28 days while cysts etc continue to grow? I’m really worried and would appreciate your input. Thank you.

  • Hi Bonita

    Unfortunately i think you will find that no one will be able to give you the answer you seek.

    I am responding out of politeness and would advise your relative to see her GP and talk through the discharge letter with them. 

    I am sorry your relative had not been given better information from the hospital Doctors.  Some doctors do not like to say anything found or biopsied to be cancerous until they have the results back. I am sure they will contact your relative when they have the results and she is scheduled for the Hysterectomy.

    I hope going forward that all will be well. x

  • Hi Bonita,

    I am sorry to hear about this confusion and the worry that it is causing you and your relative. First of all, I must say that I am not a doctor, but hope that I can help to clarify this conundrum. Scans can diagnose a mass, but cannot detect whether it is cancerous or benign. Because of the size of this mass and possibly of the appearance, a biopsy is needed to be certain. After the mass is removed, it will be sent to pathology and tested. Your relative should get the results back within 1-2 weeks and it is only then that the doctors can be sure that it is cancer.

    I agree that this has been badly handled, as this should have been explained, before your relative saw it in writing. There is a big demand for this type of surgery and waiting times vary throughout the country. Surgeons do prioritize where necessary. I suspect that 28 days is within the normal time frame. I sincerely hope that all lesions prove to be benign.

    Please keep in touch and let us know the outcome. We are always here for both of you.

    Kind regards,

    Jolamine xx

  • Hi,

    I’m not a doctor but I have experience as a cancer patient and as an NHS manager. I’ll keep this brief:-

    I’m  guessing the offer of a full hysterectomy was made regardless of whether cancer is present. At least the operation isn’t being delayed while they wait for further tests. If it isn’t cancer (they genuinely won’t know for sure until the biopsy results come through) that will be a relief - if it is cancer she can start her cancer care knowing it has been removed.

    You’re right, everything in her discharge letter should have been discussed with her in person before it was sent to her GP.

    The NHS is in crisis with over seven million patients waiting for operations etc. and no capacity to keep people in hospital while they’re waiting for an operation. The only way to operate earlier would be to operate on her ahead of someone (possibly with an even more urgent case) already on the waiting list. 

    In an ideal World, the NHS wouldn’t have been deliberately under-funded for so long (austerity measures were originally only planned for 18 months - not 13 years) but it was and cancer patients are suffering as a result. Many people are turning to the private sector to avoid such a long wait, they shouldn’t need to but it’s an option for those who can afford it.

    I hope your relative has a good outcome, I know from experience how scary it is to have such a long gap between diagnosis and treatment. 

    Best wishes

    Dave

  • Hello and thanks for posting

    This must be a worrying time for your relative and the rest of the family and I can appreciate you having some questions.

    Whilst ovarian cancer can be suspected by a consultant during some tests and investigations it can only really be confirmed through the histology report after the surgery and everything has been closely examined.

    Usually the doctor will discuss their thoughts about what might be going on with a patient and their relatives before surgery they often do say they will need to wait for the results to confirm the diagnosis and if any further treatment is needed.

    In most cases patients are best to be at home whilst they are waiting for surgery rather than in hospital. Having to wait a few weeks for surgery isn't unusual and things are unlikely to change much in this time. Of course if your relative is feeling unwell or concerned about something they should let their doctor know so they can assess them.

    I hope your relatives surgery goes well and wish her the very best. Do get back if you have more questions or give us a call to talk anything through on 0808 800 4040, we're here weekdays 9-5.

    Take care

    Naomi