Prophylactic treatment is always preferable, although a small stock of drugs can be used for emergencies. The treatment of cutaneous cancer deposits, especially those that fungate, is a challenging area in palliative care. Treatment with radiotherapy, chemotherapy and dressings is often unsatisfactory. With early referral, many procedures can be performed under local anaesthetic. Surgical resection is able to provide palliation and, occasionally, long-term survival in patients with metastatic malignant melanoma.
Patients can benefit from palliative care physicians and plastic surgeons forging closer links.
The search for a reliable and valid method of assessing nursing skills in practice has been likened to the quest for the Holy Grail. Many paths have been trodden, each with its own merits and drawbacks, making objective assessment at best, complex, and at worst, impossible. There is little, if any, agreement between educators on what constitutes practical competence in nursing and how it should be assessed. Assessments should be readable, jargon-free and focused, to make them relevant to everyday nursing practice in any given area. Nurses can be significantly empowered in their work when given baseline and developmental evidence of achievement in clinical skills.