Skip to main content

Text Size:

Contrast:

Information Hub
Introduction

Patients who are diagnosed with cancer as emergency present one of the biggest challenges in the provision of acute cancer care. 

A significant proportion of cancer patients present as an emergency. Public Health England report that the proportion of new cancer patients presenting as an emergency has fallen from 24.4% (14,813) during July to September 2020 to 19.8% (12,845) during October to December 2020. This proportion is significantly higher than the average proportion (19.4%) over the 4 years before the first national COVID-19 lockdown (between January to March 2016 and January to March 2020).

  • Diagnosis in the emergency setting is often associated with poor prognosis

  • Patients are often diagnosed with advanced disease and may require urgent and appropriate symptom management

  • Patients may present with an identifiable primary site and will be referred to the appropriate site-specific MDT for future management 

  • Patients with Malignancy of Undefined Primary Origin (MUO) will benefit from early referral to the CUP MDT

  • Acute Oncology Teams can provide advice and guidance for patients and clinicians can improve patient outcomes and experience

 

1.png

Acute Oncology Type I: Patients in whom a first diagnosis of cancer is suspected in the emergency setting

Acute Oncology Teams (AOT) have a key role in providing specialist oncology advice and guidance in Malignancy of Undefined Primary Origin (MUO) and Carcinoma Undefined Primary origin (CUP) services but also generic skills and competencies for all new emergency cancer presentations when meeting the aims and objectives for patient care which include:

  • early access to appropriate site specific teams 

  • early appropriate involvement of specialist palliative care

  • appropriate investigation/rapid diagnostics

  • psychological and emotional support for the patient and carer

  • treatment options and decision making

  • ambulatory investigation pathway if appropriate

  • discharge planning

 2.png

 

Are you a health professional looking for immediate guidance? - UKONS Acute Oncology Initial Management Guidelines - guideline 38 will help

NICE Clinical guideline [CG104] - Metastatic malignant disease of unknown primary origin in adults: diagnosis and management gives the defintions below and provides guidance for practice.

Malignancy of undefined primary origin (MUO)

Metastatic malignancy identified on the basis of a limited number of tests, without an obvious primary site, before comprehensive investigation.
Provisional carcinoma of unknown primary origin (provisional CUP) 

Metastatic epithelial or neuro-endocrine malignancy identified on the basis of histology or cytology, with no primary site detected despite a selected initial screen of investigations, before specialist review and possible further specialised investigations.
Confirmed carcinoma of unknown primary origin (confirmed CUP) 

Metastatic epithelial or neuro-endocrine malignancy identified on the basis of final histology, with no primary site detected despite a selected initial screen of investigations, specialist review, and further specialised investigations as appropriate.

 

 
 

We are eager to develop the content of this page and would be pleased to accept contributions and suggestions, please contact us if you are able to help

Please note that you should always assume that the website group, society, and authors /owners of any of these documents links or guidance make no representations or guarantees as to the accuracy, completeness or adequacy of any of the content and make no warranties express implied or otherwise and cannot be held responsible for any liability, loss or damage whatsoever caused by the use of the content. You should always act within the limits of your competence and seek senior advice or support where appropriate.