AimTo develop a management strategy (rehabilitation programme) for erectile dysfunction (ED) after radiotherapy (RT) or androgen deprivation therapy (ADT) for prostate cancer that is suitable for use in a UK NHS healthcare context.MethodsPubMed literature searches of ED management in this patient group together with a survey of 28 experts in the management of treatment-induced ED from across the UK were conducted.ResultsData from 19 articles and completed questionnaires were collated. The findings discussed in this article confirm that RT/ADT for prostate cancer can significantly impair erectile function. While many men achieve erections through PDE5-I use, others need combined management incorporating exercise and lifestyle modifications, psychosexual counselling and other erectile aids. This article offers a comprehensive treatment algorithm to manage patients with ED associated with RT/ADT.ConclusionBased on published research literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for ED after RT/ADT. In addition to implementing the algorithm, understanding the rationale for the type and timing of ED management strategies is crucial for clinicians, men and their partners.

No abstract

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.

Excoriated skin from malignant wounds or from their effluent are uncommon but difficult situations. Many preparations are available that may relieve discomfort; however, difficulties arise because such wounds often occur in areas where dressings are difficult to apply and keep in place. Lutrol gel is a thermoreversible gel, first reported as a potentially useful base substance by MacGregor in 1994. We report three cases where lutrol gel appeared to reduce discomfort, improve functional ability, and quality of life for the patient. We also discuss other potentially useful agents for similar situations.