A new toolkit from the Royal College of Physicians aims to improve the care of cancer patients admitted to hospital as an emergency with medical problems due to their cancer or their treatment.
Acute oncology on the acute medical unit is the seventh Acute Care Toolkit from the RCP, and complements the previous working party report from the RCP and Royal College of Radiologists on acutely unwell cancer patients, Cancer patients in crisis: responding to urgent needs. Thanks to improvements in the drugs and treatments available for cancer, many more people are recovering from cancer, or living longer than previously would have been the case. This has led to an increase in the number of people with cancer admitted to hospital as emergencies, due to urgent problems related to either their cancer or its treatment. In addition, one in five cancer-related emergencies are due to cancer being suspected or confirmed for the first time. Patients admitted in an emergency may see doctors and nurses who do not specialise in cancer, which may lead to poorer care. The toolkit stresses the importance of patients having access to cancer specialists as soon as possible, and suggests that NHS Trusts set up acute oncology services, which can work with the team in the acute medical unit to help in the management of patients with acute oncology problems. The toolkit includes a quick guide to common acute oncology emergencies with a focus on those that are life-threatening or could lead to further disability if not treated immediately. From an organisational point of view, it separates the key stages of patient management into challenges in the first four hours and in the first 24 hours, and how to avoid admission in the first place. For doctors working in the acute medical unit unfamiliar with the management of cancer patients, the toolkit also contains a useful guide to the signs and symptoms of side effects of common cancer drugs, and of the medical problems caused by cancer itself. Dr Ernie Marshall, consultant in medical oncology at the Clatterbridge Centre for Oncology (CCO) NHS Foundation Trust, and the author of the toolkit, said: “For patients with cancer admitted in an emergency, the best possible outcome is that their symptoms and underlying cancer are recognised quickly and they have access to expert doctors and nurses in that field. I hope that the toolkit will encourage NHS Trusts to set up acute oncology services to make that happen, and that this will lead to better treatment.”
