Abstract
ONE OF the major problems in caring for patients with advanced cancer is the presence of a large fungating or ulcerating tumor. The problem becomes severe when these lesions are associated with central necrosis, bleeding, sinus formation, and, finally, a foul-smelling, draining fistula. These problems frequently tax the resourcefulness of the physician and the nursing staff and dishearten the patient and the family. Some physicians feel so desperate that they try to avoid these patients, and a difficult period of adjustment ensues. It is not my objective to discuss the attitudinal behavior of the medical professional when faced with such a patient; rather, it is to provide practical guidelines regarding clinical management of these lesions, either in the patient's home or occasionally, in an extended care facility. A positive attitude on the part of the physician will be readily communicated to the patient. The entire situation, no matter how frustrating
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