Oncological Emergencies – Introduction
Oncological emergencies are an important and increasingly common part of Emergency Medicine, reflecting both the rising incidence of cancer and advances in cancer therapy. In the MRCEM SBA exam, these conditions are high-yield because they test a candidate’s ability to recognise time-critical complications, deliver early stabilisation, and coordinate multidisciplinary care with oncology and critical care teams.
The spectrum includes both disease-related emergencies—such as spinal cord compression, superior vena cava obstruction, raised intracranial pressure, and hypercalcaemia—and treatment-related complications, including neutropenic sepsis, tumour lysis syndrome, anaemia, thrombocytopenia, and immunotherapy reactions.
Early recognition and adherence to national guidance (e.g. NICE, RCEM Learning, and UKONS Acute Oncology guidelines) are essential to prevent irreversible harm.
This chapter provides a structured, evidence-based framework for approaching oncological emergencies in the ED, focusing on rapid assessment, red-flag recognition, and initial management.
For the SBA exam, expect questions that assess your understanding of urgent investigations (e.g. FBC, calcium, imaging), empirical antibiotic use, and criteria for admission or escalation.
Mastering this topic not only strengthens exam performance but also ensures timely, life-saving care for a particularly vulnerable group of patients.