Emergency Visits by Cancer Patients Could Be Halved – But How?

People with cancer frequently visit emergency departments for various reasons during treatment. According to a recent study, between 2012-2019, cancer patients in the US alone made approximately 36 million emergency visits. The same research presented another striking finding: 18.3 million (52%) emergency department visits by cancer patients could have been prevented. But how?

The most common complaint among cancer patients attending emergency departments was pain. The study also found that the number of visits increased over the years. If cancer patients' disease- or treatment-related problems, particularly pain, were better assessed and managed, emergency visits could be halved.

Emergency Visits in Cancer

Cancer patients may attend emergency departments most often because of pain, nausea and vomiting, shortness of breath, bleeding, infection or other disease symptoms. Worldwide, however, pain remains the most common reason bringing cancer patients to emergency care.

Pain is one of the most common and most feared complaints among people with cancer. Despite advances in cancer medicine, the frequency of cancer-related pain has not decreased over the years. Up to 60% of cancer patients experience cancer-related pain at some point in their illness.

Recent Research Data

A study published on 19 January 2023 in JAMA Network Open found that 18.3 million (52%) of 35.5 million emergency department visits by people with cancer were potentially preventable. Approximately 30% of these visits resulted in unplanned hospital admissions.

Pain was the most common reason for potentially preventable emergency visits, accounting for 37% of them.

Among cancer patients, the absolute number of potentially preventable emergency visits rose from approximately 1.8 million in 2012 to 3.2 million in 2019. Visits for pain more than doubled, from roughly 1.2 million in 2012 to 2.4 million in 2019.

The study does not explain why cancer patients' emergency visits increased over time. Possible reasons include longer survival due to more effective treatments, some cancers becoming manageable like chronic diseases, the use of multiple and newer-generation drugs, and earlier diagnosis.

Why Is Pain in Cancer Patients Not Adequately Managed?

This research does not explain why pain in cancer patients is insufficiently treated, but previous studies show that inadequate pain assessment, poor communication and failure to integrate palliative care into routine treatment may contribute. In our country, opiophobia, meaning fear or prejudice towards opioid analgesics (narcotic painkillers), may also lead to inadequate pain management.

Recent technological developments have produced mobile phone applications and computer software for assessing pain outside hospitals. Cancer pain is not easy to treat and is influenced by many factors; adequate patient assessment is the necessary first step.

Overall, this study provides a good rationale for managing adverse effects and disease symptoms better outside hospital settings during cancer treatment.