About the Acute Oncology Service (AOS), Cancer of Unknown Primary (CUP) and Metastatic Spinal Cord Compression (MSCC) ECAG

Acute oncology services aim to provide a co-ordinated approach to the care of cancer patients attending emergency departments (EDs) or who are admitted to hospital non-electively by another route with the following presentations:

  • Complications caused by the systemic treatment of cancer
  • Complications caused by radiotherapy
  • Complications caused by malignant disease, whether the primary site us known or unknown, and presenting as an acute problem or oncological emergency
  • Patients who present with a previously undiagnosed cancer

Patients with Cancer of Unknown Primary (CUP) usually present with metastatic disease (secondary cancer) and despite further investigation, the primary site of the cancer cannot be established.  Metastatic Spinal Cord Compression (MSCC) happens as a result of cancer spreading into or near the spine, which can then cause pressure onto the spinal cord.  There are pathways for the management of patients who present with symptoms suspicious of MSCC.  These patients are treated as a medical emergency as, if left untreated, MSCC can lead to paralysis.

Acute Oncology Services were developed in response to two reports, the National Confidential Enquiry into Patient Outcome and Death (NCEPOD, 2008) and a report by the National Chemotherapy Advisory Group (NCAG, 2009), along with the Measures for Cancer Services (Peer Review).  The recommendations from these reports have been embodied into the concept of Acute Oncology Services, aimed at ensuring a systematic approach is taken to dealing with cancer related emergencies.

The Acute Oncology group will be the Network’s primary source of advice on issues relating to Acute Oncology provision. The AOS ECAG’s overall aims are to provide specialist advice and guidance to the East Midlands Cancer Alliance, Clinical Commissioning Groups (CCGs), and the NHS England Specialised Commissioningon the standards of service for cancer patients who require urgent or unplanned care, reflecting current best practice.

The AOS group and its MSCC sub-group will aim to ensure that patients receive high quality, equitable care throughout the East Midlands Cancer Alliance regardless of geography or socio-economic factors and will endeavour to improve standards of care provided.