European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
-
Coping with ulcerating or bleeding tumours or metastases of the skin that are not suitable for curative or palliative treatment poses a problem for patients, doctors and nursing staff. Treatment should focus on limiting local and systemic infection, combating unpleasant odours and reducing bleeding. ⋯ Treatment depends on the nature and site of the tumour and should be tailored to and carried out in consultation with the patient, the treating specialist and the oncology nursing team. The goal of treatment is to optimize the quality of life of patients in the terminal phase.
-
We aimed to assess the number of unnecessary referrals to a specialist breast clinic, with special reference to urgent referrals, and to compare referrals with published guidelines for referral to these clinics. ⋯ There is a proliferation of guidelines (NHS, SIGN, BASO, Patients' Charter) for the organization of specialist breast clinics with the aim of providing rapid diagnosis for patients with malignant disease, or reassurance for symptomatic patients that they do not have breast cancer. However increasing numbers of patients are being referred to these clinics with minimal or no pathology, and this is not acknowledged by these guidelines. In this prospective study of referrals from primary care to a specialist breast clinic, one-third of referrals were inappropriate and this inevitably reduced the efficiency of the service provided for patients with significant symptoms.