In nursing education programs, students are taught to “consider the whole patient” in determining the plan of care based on the nursing assessment. This “holistic” approach has been handed down throughout the history of nursing practice.

The cancer patient presents a unique set of challenges to the wound and skin care specialist. This patient population has a “chronic disease state” often encompassing years of treatment including multiple chemotherapy protocols, multiple surgical interventions, radiation therapy, bioimmunotherapy, gene therapy and a host of experimental treatment modalities which can permanently alter the way in which the patient's skin will responds to external injury and will alter normal wound healing. The resulting immunosuppression and permanent radiation dermal changes can predispose the patient to skin conditions usually not seen in the general population and are difficult to treat due to the altered immune status. Progression of disease requires adjustments in the patient's therapy, further compromising and prolonging wound healing.

Wound care professionals must have a working knowledge of the surgical procedure performed and pathology, disease process and progression, and prognosis when caring for advanced cancer patients. These are critical issues in planning and maintaining effective and efficient wound and skin care.