S300 Proffered Papers The purpose of this study was to investigate women’s wishes and need for knowledge concerning sexuality and relationships in connection with gynaecological cancer. Methods: A total of 11 Swedish speaking women aged 35−70 years were interviewed following the completion of their primary oncological treatment for cervical, corpus or ovarian cancer. The data was analyzed using latent content analysis. Results: Two main categories were identified: “Absence of knowledge about the body” with four sub-categories: emotional perception of one’s own body, concerns related to changes in the body, well-being and sexuality, thoughts about the future. The second main category identified was “Conversation with sexual relevance” with two sub-categories: need for information, relationship with the partner. Conclusions: Women with gynecological cancer disease want health care professionals to initiate conversations about sexuality and partner relationships. The women wished with their partners present, to be given more in-depth knowledge about their situation given by competent staff who are sensitive to what knowledge is required. Thus, it is important that nurses, who care for women with gynaecological cancer, to meet each woman’s individual needs for knowledge about the effects on her sexuality due to her disease and treatment. References [1] Swedish Board of Health and Welfare, Description of competence for registered nurse. Stockholm (2005). [2] Cartwright-Alcarese, F.: Addressing sexual dysfunction following radi- ation therapy or gynecologic malignancy. Oncol. Nurs. Forum 22(8), 1227–1232 (1995) Medline. [3] Krumm, S., Lamberti, J.: Changes in sexual behavior following radiation therapy for cervical cancer. J. Psychosom. Obstet. Gynaecol. 14, 51−64 (1993) Medline doi:10.3109/01674829309084430. [4] Stead, M.L., Brown, J.M., Fallowfield, L., Selby, P.: Lack of communica- tion between healthcare professionals and women with ovarian cancer about sexual issues. Br. J. Cancer 88(5), 666–671 (2003) Medline doi:10.1038/sj.bjc.6600799 4170 ORAL The Smart Route to a NICE Future; Introducing a Smartcard for Patients at Risk of Metastatic Spinal Cord Compression Has the Potential to Improve Quality of Life and Save up to £17.5 Million Nationally J. Sweeney 1 . 1 Taunton and Somerset Trust, Radiotherapy, Taunton, United Kingdom Background: Early detection of Metastatic Spinal Cord Compression (MSCC) an Oncological emergency affecting 5−10% of all cancer patients, is one of the key priorities identified in the NICE CG075 (National Institute of Clinical Evidence Clinical Guideline75) [1] published in November 2008. The Department of Health (DOH) − Improving Outcomes − A Strategy for Cancer January 2011 [2], predict that by 2030 there will be 3 million people living with and beyond cancer in England; this leads to a potential minimum of 300,000 patients at risk of developing MSCC. This paper is a summary of local action taken to implement this key priority with the aim of improving outcomes and reducing costs. Material and Methods: A critical review of CG75 was carried out. A retrospective audit of all the patients with MSCC treated in Taunton with radiotherapy between May 2009 and September 2010 was undertaken and the results analysed. A short questionnaire adapted from the NICE Audit Tool was completed by staff and these results were also analysed. A potential cost saving analysis using the NICE Costing Tool was completed. Results: It was evident from the audit and questionnaire that patients at risk of developing MSCC were not being informed of the risk and what to do on symptom onset. A total of 24 patients with MSCC were treated with radiotherapy and only 5 of these were suitable for surgery due to irreversible neurological damage at presentation. Simple cost analysis showed potential local savings of £500,000 in 6 months. A Smartcard was developed outlining the symptoms and the immediate action to be taken should they occur and given to all patients at risk. This supports National Cancer Survivorship Initiative 2010(NCIS) [3] and complies with NICECG75. Conclusions: The introduction of the Smartcard will result in earlier detection, more patients eligible for surgery and improved outcomes including the potential of retaining the ability to walk for MSCC patients. The cost saving analysis based on possible reductions in emergency admissions, reduced home care costs, community nursing, and out-of- hours access for GPs illustrates the monetary savings achievable while the improved outcomes and quality of life for the patients is measureable but clearly priceless. 4171 ORAL Benefits and Barriers to Exercise for Women Living With a Breast Cancer Diagnosis S.A. Gho 1 , J.R. Steele 1 , B.J. Munro 1 . 1 University of Wollongong, School of Health Sciences, Wollongong, Australia Background: Exercise is a proven mechanism for improving physical fitness, increasing capacity for daily living tasks, and improving physical quality of life domains for women living with a breast cancer diagnosis. Despite this, exercise participation rates in this population remain low. A key part of encouraging exercise is understanding and targeting the benefits and barriers perceived by these women as they attempt to exercise. This study aims to determine perceived exercise benefits and barriers, and their effects on exercise levels among women living with a breast cancer diagnosis. Material and Methods: Female breast cancer survivors completed a validated online survey delineating their treatment and demographic background, current exercise levels, and a perceived exercise benefits and barriers scale. Spearman correlations were performed on exercise metabolic equivalent minutes per week against each perceived benefit and barrier. Results were interpreted based on statistical significance (p< 0.05) and effect size (where a ‘medium’ or greater effect size was r-value  0.30). Results: Surveys were completed by 432 female breast cancer patients and survivors aged between 23−77 years (mean 53.25±9.83 years) with 53% of respondents falling between 45 and 60 years. Only 37.4% of respondents currently met the Global Physical Activity Questionnaire recommended exercise levels. All exercise barriers queried displayed statistically significant negative associations with exercise levels. Although 10 out of 19 barriers had an effect size of r-value  30, this effect was only found in 3 out of 15 benefits. A lack of self-discipline, procrastination and a lack of enjoyment were barriers with the largest effect on exercise levels; whereas exercise enjoyment, improved feelings of well-being, and decreased feelings of stress and tension were the three benefits with an effect size of r-value 0.30. Conclusions: Over half the perceived barriers had a medium or greater effect size; a result observed in only one fifth of the perceived benefits. This indicates perceived barriers are better able to explain exercise participation than perceived benefits. Therefore, finding ways to target and reduce exercise barriers may be an effective strategy to improve exercise participation levels among women living with a breast cancer diagnosis. This study also provided a list of potential exercise barriers that should be targeted in future exercise intervention research. 4172 ORAL Arm Morbidity in Relation to Sickness Absence and Return to Work Short After Breast Cancer Surgery A. Wennman-Larsen 1 , L.M. Petersson 1 , M. Nilsson 1 , K. Alexanderson 1 . 1 Karolinska Institutet, Insurance Medicine Department Clinical Neuroscience, Stockholm, Sweden Background: Breast cancer (BC) is the most common cancer in women in working ages. Most survive and this has raised an interest in consequences from the disease and its treatments on sick leave (SL) and return to work (RTW). The primary treatment for BC is surgery, often followed by radiation, chemo-, hormone- and/or immunotherapy. It is known that many women suffer from long lasting arm problems after surgery especially in case of total axillary clearance, often with an impact on SL and RTW. What is less known are the short term consequences of surgery on these outcomes. The Swedish National Board of Health and Welfare have recommended SL up to three weeks after normal surgery for limited BC with some exceptions; “an occupation where the shoulder joint is strained and the lymph nodes has been removed, SL for up to 6 weeks of active rehabilitation may be necessary”. The aim of this study is to reveal whether and to what extent women who experience arm morbidity and that were working  75% before the BC diagnosis were on SL or had RTW within a median of seven weeks from surgery, and to describe the relationship between arm morbidity, lymph node surgery and strenuous work posture and SL or RTW, controlled for other treatment and sociodemographic factors. Material and Methods: In an ongoing prospective cohort study 725 women, 20−63 (m= 51.3) years of age, who had undergone surgery for a limited, primary BC, were included consecutively after surgery. Data from a first questionnaire, within a median of 7 weeks from surgery, and from medical registers will be presented. Descriptive as well as analytical statistics methods have been used. Results: 631 (87%) of the women were working before the BC diagnosis and 91% were working 75%. Of these 91%; 18% experienced pain in shoulder, 13% had difficulties to raise or move hand, 15% had reduced