Acute oncology (AO) teams provide expert advice and guidance to support people with cancer who attend hospital as an emergency. (This is sometimes called being acutely unwell.)

Our Acute Oncology (AO) team work closely with emergency departments (known as A&E or ED) and other teams in hospitals across Cheshire and Merseyside.

They also help to provide urgent and emergency cancer care here at The Clatterbridge Cancer Centre.  

What we do

The Clatterbridge Cancer Centre leads acute oncology (AO) care across Cheshire and Merseyside. Our consultants, nurse consultant and specialist nurses support acute oncology nurses in other hospitals. 

People with cancer sometimes need emergency care in a hospital. The three main reasons are:

  • People who do not know they have cancer until they go to hospital because they are feeling unwell. (Some people only discover they have cancer when they go to hospital for emergency care)
  • People who feel unwell because of complications or side-effects from their cancer treatment
  • People who feel unwell because of complications from their cancer – this may be because their cancer has progressed 

Acute oncology teams help staff in emergency departments (A&E or ED) and other acute and emergency teams to make sure people with cancer get the right care. They see and assess patients and provide specialist cancer advice and guidance to the teams caring for them.

This means people with cancer have rapid access to specialist cancer care. It can also help them avoid being admitted to hospital overnight if they do not need to be there.

The Acute Oncology service provides:

  • Support to people with cancer in emergency care settings
  • Advice and support to medical teams who are not cancer specialists
  • Liaison and communication between the local trust and the cancer team
  • Education and training to teams who are not cancer specialists
  • Key worker support for inpatients with a malignancy of unknown origin / cancer of unknown primary. (Malignancy of unknown origin is a term used when cancer is diagnosed in an emergency setting and it is not obvious where in the body it began without further tests. Cancer of unknown primary is the formal diagnosis given when it is not possible to tell where in the body it began, even after the usual tests.)


  • Prompt assessment and care for problems caused by cancer treatment 
  • Close liaison between emergency teams and the specialist cancer team
  • Patients need less time in hospital
  • Patients are less likely to have tests or treatment that they did not really need
  • Prompt and appropriate referrals to other specialties, as required 
  • Prompt and appropriate referrals to other hospitals, as required

The Acute Oncology team have specialist expertise in emergency care for people with cancer. This includes:

People whose cancer is diagnosed during emergency care

Sometimes people only find out they have cancer when they seek emergency care because they feel very unwell. When this happens, their cancer may already have spread to other parts of their body. It may not be obvious where their cancer started – this is known as malignancy of unknown origin (MUO).

The Acute Oncology service provides advice on tests that may help identify where the cancer started and what treatments may be appropriate. 

Complications from cancer treatment

Cancer treatments can make people feel very unwell. Some complications can be life-threatening. Others may be unpleasant but are not serious. It is not always easy for healthcare professionals who are not specialists in cancer to tell.

One life-threatening complication is neutropenic sepsis. People whose immune systems have been weakened by cancer treatment can develop neutropenic sepsis – this is where their whole body reacts if they get an infection. It is a serious medical emergency.

The Acute Oncology service provides advice and training so that emergency teams know when someone has a very serious complication and when it is less serious. 

Find out more about side-effects from chemotherapy

Find out more about side-effects from immunotherapy

Find out more about our Hotline and urgent and emergency cancer care

Complications from cancer

People sometimes develop complications as their cancer progresses and spreads to other parts of the body. Examples include:

  • People whose cancer spreads to their brain may have seizures (fits), loss of balance, blurred or loss of vision, severe headaches, difficulty speaking or other complications
  • Metastatic spinal cord compression (MSCC) – this is a serious medical emergency that can occur when cancer spreads to the spine and puts pressure on the spinal cord. The spinal cord carries nerve signals between the brain and the body. If it is compressed, it can cause permanent damage including paralysis and incontinence (loss of control over the bladder and bowels)
  • Problems in other parts of the body such as difficulty breathing if cancer has spread to the lungs 

Our team

The Clatterbridge Cancer Centre leads the acute oncology service across Cheshire and Merseyside. We work closely with acute oncology teams in other hospitals.

The Clatterbridge Cancer Centre

We have a team of consultants, a nurse consultant and advanced nurse practitioners (ANPs) specialising in acute oncology (AO). They work across our sites.

The advanced nurse practitioners support patients of The Clatterbridge Cancer Centre who suddenly become unwell (known as being ‘acutely unwell’) with complications from their cancer or their cancer treatment.

The advanced nurse practitioners are based in:

Across Cheshire and Merseyside

Consultants from The Clatterbridge Cancer Centre who specialise in acute oncology support teams in hospitals across Cheshire and Merseyside. Each hospital with an emergency department (A&E or ED) has a nurse-led acute oncology (AO) team, supported by a Clatterbridge consultant. 

We work closely with these teams so people with cancer who need urgent care of advice are seen by the right team in the right place. 

We work with acute oncology teams in:

  • Countess of Chester Hospital NHS Foundation Trust
  • Liverpool University Hospitals NHS Foundation Trust
  • Mersey and West Lancashire Teaching Hospitals NHS Trust
  • Warrington and Halton Hospitals NHS Trust
  • Wirral University Teaching Hospital NHS Foundation Trust
  • Isle of Man