The aim of this study is to develop and pilot an integrated physical and psychosexual assessment methodology that can be used, by a range of clinicians, in routine clinical practice to improve evaluation of psychosexual morbidity associated with radiotherapy for women living with pelvic malignancy. This 2-part study represents the theoretical and modelling phases of the MRC complex interventions evaluation framework (MRC 2000) and will contribute to hypothesis generation for future phase 2 and 3 studies in this area. Part 1 adopts an ethnographic approach to elicit themes and domains within the women's experience of sexual difficulties, together with participant observation of radiotherapy clinics in order to capture professional perspectives on psychosexual and educational aspects of women's care. Part 2 of the study pilots the new assessment strategy, comparing its feasibility and acceptability in routine clinical practice with an existing research instrument, the Sexual Function-Vaginal Changes Questionnaire -SVQ (Jensen et al 2003) This study informs the development of advanced practice within what to date has been a neglected and complex aspect of supportive care in clinical oncology. Clinical assessment that can elicit sexual concerns is considered an essential prerequisite for improved patient education, psychological support and referral decisions for women requiring psychosexual intervention post-treatment.