What to Know About Telehealth for Cervical Cancer

Cervical cancer refers to cancer of the cervix, the canal that connects the vagina to the uterus. It affects about 13,800 women in the United States each year, and treatment may include a combination of surgery, radiation, chemotherapy, immunotherapy, and targeted therapy. 

Some aspects of management and treatment for cervical cancer can be conducted virtually through telehealth services. Individuals with cervical cancer can get some of their care at home by phone or computer. Because of the risks of COVID-19 in the community, more and more oncology healthcare providers have been offering telehealth options for care to their patients. 

While medical offices have taken several precautions to prevent the spread of COVID-19, including investing in personal protective equipment, spreading out furniture in the waiting room, and offering online check-in, talk with your oncology team about what telehealth services they provide if you prefer to receive your care from home. 

Senior woman on a video telemedicine call with a doctor at home

Luis Alvarez / Getty Images

When to Use Telehealth for Cervical Cancer

There are several types of appointments for cervical cancer that can be conducted through telehealth. For example, screening tools meant to catch cervical cancer before it starts may be able to be used at home.

After a Positive HPV Screening

A risk factor for cervical cancer is being infected with the human papillomavirus (HPV). Most cases of HPV infection are short-lived and will go away on their own. However, when the virus stays active in the body, over time it may lead to cervical cancer. If your HPV screening comes back positive, your gynecologist may use telehealth to discuss the results and explain next steps. It may even be possible to administer a self-screening from home, then review the results with your physician via telehealth. 

After an Abnormal Pap Smear

If your routine Pap smear comes back abnormal, your doctor may be able to discuss it with you by phone or via video chat. Pap smears identify precancers on the cervix that may turn into cancer later on. There are several reasons why your Pap smear could come back abnormal, and that does not necessarily mean cancer in many cases. An abnormal or unclear Pap smear means that the cells from your cervix appear abnormal. Due to the risk of COVID-19 exposure, some gynecologists are recommending postponing routine HPV tests and Pap smears. 

Initial Oncology Appointment

Once you have been diagnosed with cervical cancer, your gynecologist will refer you to a gynecological oncologist, who specializes in cancer of the female reproductive system. Your new doctor may be able to meet with you virtually to review your lab findings and discuss recommendations for moving forward. While your oncologist will be able to discuss treatment options with you virtually, a physical exam is always needed first in order to make the diagnosis and that has to be performed during an in-person appointment.

Regular Follow-Up Appointment

Treatment for cervical cancer often involves chemotherapy and radiation. While these treatments must be administered in the hospital, your follow-up appointments may be conducted using telehealth. Your medical team will regularly check in with you while you are going through treatment to monitor your health and address any side effects. 

Post-Surgical Appointment

Your oncology team may recommend surgery to remove cancerous tissue from the cervix. Some of your post-surgical appointments may be able to be done through telehealth. You could speak with the surgeon or a representative like a nurse or a physician’s assistant. These appointments are a chance for you to ask questions and learn more about the next steps in your treatment. 

New Symptoms or Side Effects 

While cervical cancer does not typically have many symptoms, the treatments can cause several side effects. Chemotherapy can lead to nausea, vomiting, mouth sores, and fatigue, while radiation can cause skin redness and irritation, as well as fatigue. If you are experiencing any of these symptoms, check in with your medical team via a phone call or patient portal message. More serious side effects like uncontrolled vomiting and diarrhea, mental confusion, and bleeding require an urgent in-person visit for evaluation and treatment.

You will also need to be seen if your surgical incisions are red, painful, and oozing discharge. These are serious signs of an infection.

Sexual Dysfunction

It is common for individuals undergoing treatment for cervical cancer to experience a change in sexual function and quality of life. A 2016 study found that 78% of respondents reported sexual dysfunction related to therapy side effects. Talk with your medical team via telehealth if your quality of life has suffered since they can offer additional resources and referrals if needed. 

Mental Health Services

Women are twice as likely as men to experience depression during their lives, and the risk goes up with a cancer diagnosis. Many services like mental health screenings and therapy appointments can be conducted using telehealth. Talk with your doctor if you are concerned about your mental health and want to seek help.

Cervical cancer may not have any early warning signs, so as soon as you develop symptoms, it’s important to be seen by a gynecologist right away. Abnormal vaginal bleeding and painful intercourse could be signs of cervical cancer.

Other cervical cancer appointments that require an in-person visit include: 

  • A pelvic exam or repeat Pap smear
  • An appointment for chemotherapy or radiation
  • A high fever
  • A preoperative physical exam 

Benefits and Challenges

Receiving some of your oncology care from home can help to reduce your risk of COVID-19. This is especially important because patients with cancer are about twice as likely to contract COVID-19 as the general public. They have compromised immune systems from cancer treatment and cancer itself. Utilizing telehealth services as often as possible can reduce cancer patients’ risk of being exposed to COVID-19. 

Telehealth appointments are usually more convenient as well. Some cancer treatments can be administered at home, and your medical team can monitor you via phone or video chats. Some intravenous (IV) chemotherapy medications can be switched to oral preparations. Your hospital may be able to send a lab technician to your house to perform blood draws, rather than having you come into the hospital lab. 

Studies show that telehealth services save time and increase access to care. A 2020 study found that 82% of women with breast or gynecological cancer felt that using telehealth services like patient portals and virtual appointments improved their overall health. 

Potential drawbacks include the need to learn the telehealth system and reimbursement rates. Patient portals and telehealth services may be confusing and take time to learn how to navigate. There are no federal guidelines on how to reimburse telehealth visits, and patients can sometimes be surprised by a hospital bill afterward. Finally, telehealth visits are not substitutes for physical exams.

How to Prepare for a Telehealth Visit for Cervical Cancer

Before your first virtual visit, you may find that telehealth appointments take a bit more prep work than in-person visits. First, make sure that you have a device with access to high-speed internet. Ask your clinic’s representative if you will be talking on the phone or using video chat, as well as which providers will be on the call. Call your hospital’s billing department to find out if the visit is covered by insurance. 

On the day of your appointment:

  • Find a quiet place in your home where you’ll be able to talk with your provider without interruptions. If you are using a public computer, bring headphones.
  • Install any needed software and test out the camera and microphone on your device. Ask a relative or friend for help if you’re having trouble getting set up.
  • Make sure your device is charged and that you have the phone number for the clinic in case you are disconnected.
  • Think through the questions you’d like to ask and any updates for your team. Keeping written notes with you may help.
  • Write notes about any changes to your treatment plan, including medications, chemotherapy schedule, or radiation therapy.

Will Insurance Cover Telehealth for Cervical Cancer?

In 2020, the U.S. Congress passed three federal stimulus packages that aimed to expand access to telehealth services, especially for Medicare recipients. The new laws removed the geographic restrictions and eligibility requirements. Because each state varies in how they enforce the new rules, check in with your medical provider and insurance carrier. When researching telehealth coverage, a good starting place is the National Consortium of Telehealth Resource Center, which offers a database of telehealth billing policies by state.

What Happens During the Visit

Your telehealth visit will most likely feel similar to an in-person appointment. You and your physician (or doctor’s representative) will sit down to discuss your health and treatment. 

Before starting the visit, you may be asked to acknowledge the fact that you understand the limitations of a telemedicine visit, including the inability to do a full medical exam, possibly missing subtle findings that might have been obvious during an in-person visit.

You have the right to refuse to participate in services delivered via telemedicine and ask for an in-person visit.

Appointment With a New Provider

If you are meeting a doctor for the first time through telehealth, be prepared to discuss your family’s health history, especially any family members who have a history of cervical cancer. Your new doctor will take a detailed history and review your most recent lab findings. Your doctor may share their screen with you to show you lab results or written treatment plans. You may also be asked to give a formal written or verbal consent for the telemedicine visit before it starts.

Follow-Up Visits

For follow-up visits, your provider will ask about how you have been feeling and any new symptoms or treatment side effects. It may help to keep written notes with you so that you do not forget to tell your doctor about any new developments. Your provider may also share results from your recent labs or scans. 

Your provider will discuss the next steps and treatment plans. Be sure to ask questions and take notes. Ask your provider when they will need to see you in person again, as well as about any lab tests or procedures you may need.

During telehealth visits, you are entitled to privacy just as you are during in-person appointments. Providers offering telehealth visits must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and protect your health information during and after the appointment. Protected health information includes your name, date of birth, diagnosis, and more.

Health providers must use “any non-public facing remote communication product that is available to communicate with patients.” 

A Word From Verywell

Undergoing care for cervical cancer has most likely been one of the most challenging times of your life. While telehealth services cannot ease your pain, they may make treatment slightly more convenient and safer during the COVID-19 pandemic.

Ask your medical team about using telehealth for regular appointments and questions about treatment. Check with your hospital’s or provider’s office billing department about which telehealth services are covered by your insurance. However, telehealth cannot cover all aspects of your medical care, and it’s important to know when you may need to see your provider in person.

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Article Sources
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