Acute Oncology in the NHS

The NHS is constantly changing to meet patients’ needs. The goal is simple – to ensure every patient receives the medical care and attention they need as quickly as possible. That’s why acute oncology services have become increasingly common in recent years.

So, what is acute oncology and is it a branch of medicine worth going into? As an international medical graduate, acute oncology might be brand new to you, so we have collated all the essential information on it. Who knows, you may just discover that acute oncology is where you would thrive best in the NHS!

What is Acute Oncology in the NHS?

First, let’s understand exactly what acute oncology means. You are likely familiar with the two words separate from each other – acute care refers to specialist support and treatment for patients who need urgent attention, and oncology refers to specific care and treatment for cancer patients.  

Acute oncology branches the two. It’s a subspecialist branch of medicine that handles acute conditions in cancer patients, whether the acute condition is due to cancer treatment (such as radiotherapy) or the cancer itself. In these situations, the cancer patient needs urgent treatment, and the acute oncology services provide that promptly in the correct setting. As a result, patients are more likely to receive the proper care they need and are more likely to recover well from the acute symptoms.

When was Acute Oncology Introduced?

The beginning of acute oncology was marked in 2009, when a report from the National Chemotherapy Advisory Group suggested that every hospital with an emergency department should also include acute oncology services. Since then, NHS hospitals all throughout the UK have offered these services to cancer patients (or suspected cancer patients) who require acute treatment.

Acute Oncology vs. Clinical Oncology Work

Working in acute oncology is quite different from doing clinical work in oncology. Clinical oncology involves caring for cancer patients through cancer treatments such as radiotherapy and chemotherapy. On a typical day, a clinical oncologist will often work alongside a multi-disciplinary team to create the best treatment plan for their cancer patients. Often, this means using the latest and most innovative technological advancements in medicine.

On the other hand, acute oncology deals directly with acute systems of cancer patients. Rather than dealing with a patients initial cancer treatment plan, acute oncologists will be supporting cancer patients admitted to hospital who are unwell with complications of their cancer or side affects of their cancer treatment. Due to this, the role will likely be more fast paced and certainly less predictable. 

Why is Acute Oncology So Important?

Acute oncology is a relatively new subspecialty in the NHS. You might wonder, why was it developed? There are a few reasons for this.

The Development of New Therapies/Treatments

With the ongoing development of new therapies and treatments for cancer patients, it’s important to have acute oncologists on hand in case something goes wrong as there are always variables here. New treatments might bring on new acute symptoms, and having a team that can specifically handle that means cancer patients receive a higher quality of care.

The Toxicity of Cancer Treatments

Unfortunately, many cancer treatments result in toxicities. While these treatments are necessary to target the cancer, these toxicities can result in unpleasant and dangerous symptoms for the patient. One example is neutropenic sepsis, which can occur in patients who receive anti-cancer therapy. By having a team of acute oncologists on hand, patients experiencing signs of neutropenic sepsis can get the necessary treatment they need sooner rather than later. It helps to have experts on hand.  

The Increase in Cancer Patients

The number of cancer patients seeking NHS treatment is only growing. Data shows that there was a 133% increase in people tested for cancer from 2013 to 2022. With this surge, it’s important that these patients receive adequate, all-around care. Having acute oncologists on hand provides some relief for clinical and medical oncologists.

Separation of Treatments

Acute services in the NHS are already overrun, and cancer patients put more strain on that. Acute oncology aims to alleviate some of that strain. By having dedicated acute oncology services, emergency departments won’t have so many patients passing through. This separation of treatments makes the care of cancer patients far more organised overall.

Overall, the inclusion of acute oncology services within NHS hospitals is about improving medical treatments for cancer patients while also helping create a more organised system.

The Patients You Work with in Acute Oncology

If you work in the acute oncology department, the patients you treat will fall under one of the following three categories.

Patients with a Suspected Case of Cancer

The world of medicine can get a little complicated, and the development of acute medicine aims to reduce that complication. The acute oncology team’s services involve treating patients who have a suspected case of cancer but have not yet been diagnosed. It’s an excellent way of ensuring that patients showing acute illnesses can get the treatment they need for a suspected case.

Acutely Ill Patients Due to Non-Surgical Treatments

These patients become acutely ill due to non-surgical cancer treatments, such as radiotherapy, chemotherapy, steroid therapy, and target therapy.  

Acutely Ill Patients Due to Their Cancer

These patients develop acute symptoms because of the cancer itself. At this point, the cancer is known.

Common Types of Conditions and Treatments

What about the common types of conditions and treatments the acute oncology department handles? Of course, every patient is someone with cancer (or suspected cancer), but here, we can look at more of the specifics. Some of the most common issues the AOS deals with include:

• Low Red Blood Cells
• Infections
• Blood Clots
• Compression of the Spinal Cord
• Abnormal Levels of Sold
• Excess Fluids (such as in the lungs)
• Vomiting

Sometimes, these symptoms come on due to the treatment of a cancer, and other times, it may be due to the cancer itself. Either way, the acute oncology team will treat it.

What Would a Typical Day Look Like?

A typical day of working in acute oncology can vary greatly. 

Let’s start with the setting – as an acute oncologist, you’d likely be stationed in:

• A&E
• Oncology Units
• Cancer Hospitals
• Acute Oncology wards 

The setting would usually be very fast paced due to the nature of the services – you’d be dealing with patients who need emergency medical attention, rather than those attending an outpatient clinic.

Throughout the day, you will see a large number of patients, some of whom have known cancers, some with malignancy of unknown origin, and some with cancer of unknown primary. These patients will show a variety of acute symptoms, including things like excessive fluids in the heart and high salt levels. They will need fast medical treatment.

In terms of who you work with, you’d be treating patients alongside a multi-disciplinary team made up of both nurses and doctors. With combined efforts, patients receive the best treatment for their acute symptoms.

The Benefits of Working in Acute Oncology

There are so many benefits to working in the acute oncology department. If you have a specialised interest in treating oncology and want to be a part of a still-developing subsection of the NHS, it could be the perfect department for you. Here are some of the positives.

Work in a Multi-disciplinary Team

When you work as part of the acute oncology department, you aren’t alone. You are surrounded by a hard-working, multi-disciplinary team. Everyone pitches in, and everyone can be proud of the work done each day.

Fast-paced

If you like a fast-paced, exciting environment, then acute oncology is a great place for you to work. There’s never a dull day; each case is different, and you will always be on your feet with a new patient to treat.

Be Part of Something New

The medical world is always evolving, and it’s exciting to be a part of that. With acute oncology being quite new as a service, you get to be a part of the fantastic new changes that come with working from the NHS – as a result, your input and experiences mean a lot. Your ideas may even shape the future of acute oncology.

Helping People Who Need it Most

Cancer patients always go through so much struggle, and it becomes even more difficult when they develop scary acute symptoms. As a doctor in acute oncology, you get to be at the front of the line, helping those people overcome their symptoms and, in many cases, get better. Making such a difference in people’s lives is truly magical.

Availability of Junior positions 

Oncology is a Consultant led specialty, which means the general demand is at a senior level. For international medical graduates who are relatively junior, this means the job search is going to be a little bit trickier – as junior jobs are highly competitive. Acute Oncology is more comparable to Emergency and Acute Medicine in terms of job market, and therefore has more available vacancies at one given time on Junior/Middle Grade rotas. Although however needs a strong tier of Junior/Middle Grade however is a growing market, with many Trusts requiring doctors at 

Great stepping stone for getting into training

Whether it’s higher Oncology Training or IMT, an Acute Oncology role has great prospects. Given it’s exposure to a variety of different patients and it’s cross between Internal, General & Acute Medicine.. many doctors choose Acute Oncology as a stepping stone to training. 

The Challenges of Working in Acute Oncology

Of course, working in acute oncology isn’t a walk in the park. It’s not for everyone, and there are some definite challenges you should be aware of before making it your career goal.

Dealing with Death

Due to the nature of the subspeciality, those working in acute oncology will have to handle patients dying. It’s very hard and upsetting, and you need to be emotionally resilient to handle that day in and day out. Some people handle it better than others.

It’s New

While the subspeciality being new is exciting, it also means studying can be a little harder. Here’s what Katie Fleming, an acute medical Consultant, had to say about the challenges involved:

“As acute oncology was only just starting to come into the curriculum for oncology trainees, it was a bit difficult to know exactly what I should be spending time doing. However, for me, I had already had inpatient oncology experience dealing with acute issues, so my knowledge needed to be expanded in the area of treatment regimes, common side effects and immunotherapy, so this is what I focused on, alongside seeing inpatient referrals that the oncologists would receive.”

Of course, with the subspeciality being relatively new, there will be improvements along the way. As part of the department, you could even be a part of those changes. In an interview with The Guardian, an acute oncology nurse had this to say about what she’d like to see changed:

“In an ideal world, I’d like to see every district general hospital have a specialist cancer ward – and more support in the community. I’d also love to see health professionals explaining things better to people. It’s all about communication.”

Skills You Need to Work in Acute Oncology

So, are you wondering if working in acute oncology is right for you? As demonstrated, the work isn’t easy, and you’ll need a range of skills to help you thrive and succeed in this career. Here are some of the most crucial.

Knowledge of Systemic Anti-Cancer Treatments

First, you must be familiar with anti-cancer treatments and how they work. Many people in the acute oncology department complete their training in medical oncology, which gives them the specialised knowledge they need to treat acute cancer patients.

Advanced Communication Skills

You’ll be working alongside a multi-disciplinary team and a variety of cancer patients, which means your communication skills must be stellar. You need to communicate clearly and empathetically. Often, you’ll be communicating about complex cases and treatments. This is a skill you can usually build up throughout your training, and it’s one to really focus on.

Can Work in Fast, Intense Situations

Working in the acute oncology department means dealing with complex cases quickly. You’ll need to be quick on your feet and able to come up with solutions on the spot.

How to Get Started

Does the thought of working in acute oncology interest you? That’s great news! It’s an exciting and ever evolving subspecialty that requires the very best doctors. So, how do you get started?

The best route is to begin with either an ACCS in acute medicine or core medical training. These will allow you to apply to ST3+ positions in medical or clinical oncology. By training in medical or clinical oncology, you can begin to specialise in the acute oncology subspecialty.

Do you have questions on how to work in the acute oncology department in the UK? Are you wondering how your experience in your home country translates? We can help. Whether you’re a junior doctor or a highly specialised oncologist, we can answer any questions you have about becoming an acute oncologist in the UK. Get in touch to get started on your journey. 
 
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