ONCOLOGY & EMERGENCY MEDICINE - WHEN TIME DETERMINES OUTCOME

In our daily practice, we encounter situations when an oncology patient presents to a physician of another specialty, which may cause some tension and additional caution, as the management of such patients is often considered more complex. It is commonly believed that a clinical oncologist should be involved from the very beginning. However, in some acute situations, there is no time for delay, and the patient requires prompt and appropriate medical care. The aim of this discussion is to demonstrate the importance of timely recognition and initial management of emergency conditions in oncology patients, particularly for specialists in emergency medicine. Emergency medicine and oncology are closely connected, and effective collaboration between specialists is important for appropriate patient management and clinical outcomes. We will present several clinical cases from our practice and discuss the main issues that are important for emergency medicine specialists to recognize. The focus will be on situations in which the emergency physician needs to make an initial decision and provide urgent medical intervention before the oncology team is involved, as well as cases requiring immediate involvement of the appropriate specialist. Oncological emergencies are diverse. The clinical cases presented include tumor-induced brain compression, bowel obstruction, and cardiac tamponade. Each case will be discussed in terms of clinical presentation, early warning signs, initial evaluation, emergency intervention, and the timely involvement of relevant specialists. Particular attention will be given to the role of the emergency physician during the initial phase: rapid evaluation of the patient's condition, recognition of life-threatening situations, hemodynamic and respiratory stabilization, and prompt decision-making, as any delay may lead to further clinical deterioration. Learning from real clinical cases helps physicians connect theoretical knowledge with practical situations. This discussion aims to help physicians from different specialties better recognize the main clinical features of oncological emergencies, establish priorities for initial management, and ensure timely involvement of the appropriate specialists, including an oncologist, surgeon, neurosurgeon, or cardiologist. The management of an oncology patient should not be considered the responsibility of the oncology team alone. The cases discussed demonstrate that early recognition, accurate initial evaluation, and timely intervention are essential. Effective collaboration between emergency medicine and oncology teams plays an important role in this process.