A group of interested professionals was convened to develop some evidence-based recommendations on the management of salivary gland dysfunction (SGD) in oncology patients. A Medline search was performed to identify the literature on SGD. The abstracts of all identified papers were read, and the full texts of all relevant papers were reviewed. The evidence was graded according to the Scottish Intercollegiate Guidelines Network grading system for recommendations in evidence-based guidelines. The summary of the main recommendations are: (1) patients with cancer should be regularly assessed for SGD (grade of recommendation - D); (2) the management of SGD should be individualised (D); (3) consideration should be given to strategies to prevent the development of radiation-induced SGD (C); (4) consideration should be given to treatment of the cause(s) of the SGD (C); (5) the treatment of choice for the symptomatic management of SGD is use of an appropriate saliva stimulant (C); (6) consideration should be given to prevention of the complications of the SGD (D); (7) consideration should be given to treatment of the complications of the SGD (D); and (8) patients with SGD should be regularly reassessed (D).

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The assessment and management of fungating wounds is a challenging situation which necessitates nurses using many skills. Literature is limited, especially relating to the psychological issues that arise for the patient and his/her family. As nurses, we must begin to address this by considering how our philosophy, knowledge and theory impact on and inform our practice. This article will critique and explore the different influences that affect our way of being and thinking in the world and how we can guide practice by using our fundamental skills of caring.

Patients with cancer or those undergoing palliative care may have complex and/or chronic wounds accompanied by a range of distressing symptoms. Therefore, the management of these wounds is primarily aimed at reducing their impact on patients and their families (Laverty et al, 1997). An interdisciplinary Wound Management Group was set up at The Royal Marsden Hospital with the aim of promoting good quality wound management and care for patients with cancer. This article highlights the ways in which this Group has been instrumental in facilitating best practice while outlining the difficulties in ensuring evidence-based care where little research has been conducted into the efficacy of wound management interventions for complex and/or chronic wounds.