title: Responding to Acute Care Needs of Patients With Cancer: Recent Trends Across Continents.
abstract: Remarkable progress has been made over the past decade in cancer medicine. Personalized medicine, driven by biomarker predictive factors, novel biotherapy, novel imaging, and molecular targeted therapeutics, has improved outcomes. Cancer is becoming a chronic disease rather than a fatal disease for many patients. However, despite this progress, there is much work to do if patients are to receive continuous high-quality care in the appropriate place, at the appropriate time, and with the right specialized expert oversight. Unfortunately, the rapid expansion of therapeutic options has also generated an ever-increasing burden of emergency care and encroaches into end-of-life palliative care. Emergency presentation is a common consequence of cancer and of cancer treatment complications. It represents an important proportion of new presentations of previously undiagnosed malignancy. In the U.K. alone, 20%-25% of new cancer diagnoses are made following an initial presentation to the hospital emergency department, with a greater proportion in patients older than 70 years. This late presentation accounts for poor survival outcomes and is often associated with poor patient experience and poorly coordinated care. The recent development of acute oncology services in the U.K. aims to improve patient safety, quality of care, and the coordination of care for all patients with cancer who require emergency access to care, irrespective of the place of care and admission route. Furthermore, prompt management coordinated by expert teams and access to protocol-driven pathways have the potential to improve patient experience and drive efficiency when services are fully established. The challenge to leaders of acute oncology services is to develop bespoke models of care, appropriate to local services, but with an opportunity for acute oncology teams to engage cancer care strategies and influence cancer care and delivery in the future. This will aid the integration of highly specialized cancer treatment with high-quality care close to home and help avoid hospital admission.
authors.affiliation: St. James's Institute of Oncology, St. James's University Hospital, Leeds, United Kingdom a.young@leeds.ac.uk.
authors.forename: Alison
authors.initials: A
authors.lastname: Young
authors.affiliation: Medical Oncology, Clatterbridge Cancer Centre, Merseyside, United Kingdom.
authors.forename: Ernie
authors.initials: E
authors.lastname: Marshall
authors.affiliation: Princess Margaret Cancer Centre, Toronto, Canada.
authors.forename: Monika
authors.initials: M
authors.lastname: Krzyzanowska
authors.affiliation: Christchurch Hospital, Christchurch, New Zealand.
authors.forename: Bridget
authors.initials: B
authors.lastname: Robinson
authors.affiliation: Medical Oncology, Clatterbridge Cancer Centre, Merseyside, United Kingdom.
authors.forename: Sean
authors.initials: S
authors.lastname: Brown
authors.affiliation: St. James's Institute of Oncology, St. James's University Hospital, Leeds, United Kingdom.
authors.forename: Fiona
authors.initials: F
authors.lastname: Collinson
authors.affiliation: St. James's Institute of Oncology, St. James's University Hospital, Leeds, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Seligmann
authors.affiliation: Diabetes Center, School of Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Afroze
authors.initials: A
authors.lastname: Abbas
authors.affiliation: NHS Leeds West Clinical Commissioning Group, Leeds, United Kingdom.
authors.forename: Adrian
authors.initials: A
authors.lastname: Rees
authors.affiliation: St. James's Institute of Oncology, St. James's University Hospital, Leeds, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Swinson
authors.affiliation: Medical Oncology, Clatterbridge Cancer Centre, Merseyside, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Neville-Webbe
authors.affiliation: St. James's Institute of Oncology, St. James's University Hospital, Leeds, United Kingdom University of Leeds, Leeds, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Selby
mesh_terms: D004632:Emergency Medical Services; D006801:Humans; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D016522:Oncology Service, Hospital; D057285:Precision Medicine; D011379:Prognosis; D006113:United Kingdom
keywords: Acute oncology; Cancer outcomes; Emergency cancer care; U.K. oncology