Symptom management Resources

Rectal cancer is common in the UK, affecting about 12,000 people each year. The common treatment for rectal cancer is surgery, such as an anterior resection which may also be combined with chemoradiation. Treatment for rectal cancer, however, is likely to cause subsequent problems with bowel function. Changes to the bowel can present with faecal incontinence and the need to rush to the toilet. Nurses can assist with some simple interventions, such as medication to bulk up the bowel motion or changes to the diet to thicken the bowel motion. If symptoms are severe and are not resolved using these methods, there are other interventions that can be tried, such as sacral nerve modulation which will require referral to a specialist.

Fungating wounds can have a devastating effect on patient quality of life. Common symptoms, such as bleeding, odour, and excessive exudate production can also cause feelings of shame for the patient, resulting in social isolation. General assessment should determine the patient’s physical, psychological and emotional status, and how the family is coping. Wound assessment is crucial to determine the extent of any symptoms, to identify concerns of the patient and family, to form a baseline against which to measure wound progress, and to identify management goals. Use of a tool such as the Triangle of Wound Assessment promotes a systemic approach to wound evaluation, helps with data collection and recording, and can help to identify treatment goals. This article outlines the key principles of the assessment and management of fungating wounds, and presents a case report describing the use of the Triangle of Wound Assessment to successfully manage a patient with a fungating wound, using a conformable, silicone foam dressing impregnated with silver.