Emergency oncology: The situation of acute general hospital in Japan.

Abstract

e18069 Background: The need for supportive and palliative care services for cancer patients is well established. Our hospital is acute general hospital with 602 beds, 20 ICU beds, radiation unit, chemotherapy unit and with emergency department(ED) 24hours and 365 days open, locates close to one of the national cancer center. In this situation, we have many acutely unwell patients with newly diagnosed cancer in emergency department(emergency oncology). Methods: We reviewed the records of the patients with newly diagnosis of cancer and treated by surgery, radiation and or chemotherapy and of the patients transfered by ambulance at ED in 2017, 2018 and 2019, retrospectively and consecutively. Results: In this three years, we have 1626 patients with first diagnosis of cancer, 268 patients visited after clinic-hour and 130 patients needed ambulance with critical symptoms. Of those, 145 had gastro-intestinal, 34 hepato-billiary, 25 urological, 24 lung, 16 gynecology, 9 breast and 23 other cancer. During this period, total 30027 patients were transported by ambulance to our ED. Conclusions: Although there are many cancer centers in Japan, there are only one unit in Japan.(National Cancer Center Hospital(Tokyo) )that provide urgent care to cancer patients. In this situation, acute hospitals have to have a role for emergency oncology. We need varying models of emergency and acute care development (e.g., acute cancer net-work system, regionalization, education for the physicians and patients, organize the emergency oncology unit in acute hospital or cancer center) with cooperation of oncologist and non-oncology emergency physicians in Japan as they are trying and developing in the USA and UK.