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The development and delivery of acute oncology services, both nationally and internationally, have undoubtedly improved the care of cancer patients, the management of acute complications of cancer and its treatment, and our approaches to diagnosing patients who present with cancer and no obvious primary site. The development of acute oncology services has addressed the needs of patients who present acutely to the healthcare system with findings that suggest the possibility of a malignancy, by ensuring they get access to early specialist oncology input. This reduces delays in diagnosis and in the inappropriate investigation of patients too unwell to be considered for systemic anticancer treatment, and facilitates the timely start of treatment. The development of acute oncology services has also ensured that patients who develop acute complications of their cancer or their treatment are seen, evaluated and managed promptly by clinicians with the right skills and facilities, and are provided with a supportive and holistic acute cancer care service throughout their journey. Key appointments in acute oncology, many at consultant and nurse practitioner level, have been made across the NHS and there is continued growth and expansion.

There remains a need to ensure that practitioners are kept fully informed and up-to-date about the appropriate clinical care to be provided in the setting of acute oncology. It is also important to continue a dialogue on the best way to deliver acute oncology services in a hard-pressed healthcare service. Since the first edition of Problem Solving in Acute Oncology was published in 2014, there has been continued development and expansion of services across the UK. The importance of the involvement of primary care in delivering acute oncology nationally has been increasingly recognized, leading to the development of ever stronger links between the two. Closer working with acute medicine physicians has also improved the care of acute oncology patients; work is ongoing to encourage closer collaboration between acute oncology services and clinical haematology.

The establishment of a biannual national acute oncology conference has provided a valuable opportunity for the multidisciplinary members of acute oncology teams nationally to share best practice and innovation. This updated text is particularly helpful and timely. It will again serve as a valuable resource for those who continue to develop excellent acute oncology services, as well as provide a source of training and an update for clinicians working in this challenging clinical area. The Association of Cancer Physicians is to be congratulated for bringing about this valuable additional resource, which is the seventh book in the Problem Solving series. We may look forward to further contributions in the future.

Alison Young, Ruth E. Board, Pauline Leonard, Tim Cooksley, Andrew Stewart and Caroline Michie, Editors

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