What happens when a cancer patient goes to the emergency room: 4 useful tips and (urgent) problems to solve |

Symptoms, serious events (such as infections or thrombosis), side effects of treatment are the most common causes.In half of the cases, the patient is hospitalized

What happens when a cancer patient goes to the ER: 4 useful tips and (urgent) problems to solve

Symptoms, acute events (such as infection or thrombosis), and side effects of treatment are the most common causes. Half of the cases are hospitalized.

3.7 million Italians have been diagnosed with cancer, or more than 6 in 100 of their compatriots.Almost all patients with advanced cancer have had at least one "unplanned" hospital visit during their medical history.What is the reason?Conditions caused by a neoplasm, other acute events (such as infection or thrombosis), or side effects of treatment.This phenomenon is destined to grow for at least three reasons.That's because the number of people being diagnosed with cancer is increasing, because these people are living longer and longer (and treatment is taking longer), and because most of them are older, more frail, and often already have other medical conditions other than cancer.And since statistics show that more than half of cancer patients admitted to emergency rooms (EDs) require a subsequent (usually longer than average) hospitalization, there are some urgent issues that need to be addressed, starting with the availability of beds and specialized medical and nursing staff, without neglecting the establishment of "special pathways" to facilitate and speed up admissions.

Reasons for emergency care: symptoms

The Italian situation is mapped by the investigation contained in the report of the Federation of Voluntary Oncology Associations (Favo) 2025, coordinated by the Italian Support Network in Oncology (Nicso), in collaboration with the Italian Association of Medical Oncology (Aio) and the Italian College of Heads of Hospital Oncology (Cipo Physical Oncology group).What brings a person with cancer to the emergency room?" "Symptoms" are definitely the most common cause of admission to the hospital, covering about 50% of cases - answers Gianmauro Numico, director of medical oncology at the S. Hospital.Croce e Carle in Cuneo and board member Nixo.Pain, jaundice, dyspnea in the presence of a neoplasm that affects (due to a primary mass or metastasis) the respiratory system, neurological symptoms, intestinal obstruction are some of the most common examples.Disorders that in many cases require not only treatment aimed at reducing symptoms, but also tumor-specific treatment (mainly radiation therapy).25-30% of cancer diagnoses occur during hospitalization for acute-onset symptoms: that is, more than a quarter of cancer diagnoses today occur through an emergency room visit.

Reasons for emergency admission: acute and toxic events

Another second reason (30% of cases) that can bring cancer patients to the emergency room is an "acute event" that is not directly related to cancer (such as an infection): in this case, although the presence of a tumor can worsen the prognosis, the treatment is no different from that of people without a tumor."Another 20% of patients are hospitalized due to the side effects of cancer therapy, whose treatment requires the suspension and use of procedures (often clearly identified) of specific supportive therapy, - explains Andrea Antonuzzo, Head of Medical Oncology 4, Internal and Geriatric Support at the Milan National Cancer Institute IRCCS Foundation and member of the Board of Directors which cannot be ignored by the fact of cancer 5% that we estimate. in the hospital, so admission to the ward is also frequent at the end of life".

From hospital admission to hospital admission

Estimates also show that between 3 and 10% of people who go to the emergency room have a history of cancer, and when a person has cancer, more than half of emergency visits end in hospitalization, compared to 10-15% in non-oncological cases." Worried or supportive family members - says Monica Giordano Cipomo Hospital Secretary and Director of Complex Oncology Regardless of the reasons that bring them to the hospital, statistics show that,compared to the rest of the population, the hospital stay is longer, the hospital mortality rate is higher and the most important management problem is, at this stage, bed availability in Europe20 has decreased by 35%.

Litch SOS

According to the latest available data, there are 4797 oncology beds in our country, which is 2.3% of acute care beds for hospitalized patients.According to the Favo report, it is significantly less than it should be.Regardless of the fact that, first of all, large hospitals (such as IRCCS, cancer institutes, hospital-university polyclinics) have oncology departments with a shortage of beds scattered throughout the national territory.the centers."Often, in institutions without specialized beds, the patient is sent to the emergency room for clinical problems that require hospitalization," says Massimo Di Maio, president of Aiom.And hospitalization is mostly prescribed in departments of internal medicine, geriatrics or other specialized hospitalization departments (balancing clinical reasons and logistical needs).In these cases, it is necessary to create integrated models of joint care of specialists and other specialists. to ensure the availability of all the necessary skills to oncology clinics and day hospitals for the management of clinical problems - continues Di Maio -: in many cases, a good organization of oncology services prevents the patient from entering the emergency department.

A solution to the problem

The findings also point to possible solutions.There are five key points.According to experts, we need: oncologists and specialist nurses who can work most of the day or exclusively in this function; in particular, nurses who can play the role of admission triage and address an important part of requests for information and intervention; emergency access to a range of essential services (especially laboratory tests, radiology and specialist consultations) to guarantee a speedy completion of the process; close and continuous integration with emergency departments, where inpatient and specialized skills are required;

Practical advice if you choose PS

Finally, if you need to go to the emergency room, experts offer some practical ideas:

Always carry a list of your current treatments (both cancer and other drugs) with you, and it is best to have your latest cancer screening card with you.

- In an emergency, the safest thing to do is go to the nearest emergency room (not necessarily a cancer hospital).

- If possible, visit an emergency room where you are in contact with your healthcare team and/or family doctor to filter true needs.

- Follow the instructions of the emergency doctor regarding the treatment of the problem for which you sought help (and if hospitalization is recommended, it is reasonable to refuse).