Specialized urgent care for cancer patients is becoming more accessible in Philly

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As Ellie Wilson waited for her name to be called at a Philadelphia emergency room, she felt nervous and uneasy. She found herself surveilling the other patients.

“You have parents with their young children who are coughing, stifling, sneezing … and that’s all coming out in the air,” she said. “You’ve got a man six seats down from you, puking in a bucket.”

All of this felt like a threat to her and her extremely compromised immune system. Wilson, a Pennsylvania resident, was diagnosed in July 2023 with triple-negative breast cancer.

“When you have a disease like this, and it compromises every inch of your body, you have to think about what the other people around you are doing,” she said. “And it’s terrifying.”

Before learning that she had this aggressive form of cancer, Wilson had already been diagnosed with ulcerative colitis, a chronic inflammatory disease that causes inflammation and ulcers along the lining of the colon. The combination of chemotherapy and this other existing condition landed Wilson in the ER for gastrointestinal issues during the duration of her treatment, especially since cancer treatments often come with gastrointestinal issues like nausea and vomiting.

Trips to the ER are not uncommon for oncology patients. During treatment, patients in this population experience side effects such as nausea, vomiting, fatigue and even blood clotting.

But when patients cannot schedule a quick appointment for their acute but immediate needs, they often turn to the ER, where they may be exposed to infectious diseases. Cancer centers in Philadelphia have been filling this gap by providing oncology urgent care, specialized clinics that serve cancer patients who experience side effects from treatment that need immediate attention.

The University of Pennsylvania’s Abramson Cancer Center’s clinic, the Oncology Evaluation Center, recently extended its hours to be available 24/7.

“We wanted a solution for our patients so they could spend as much time as possible outside the hospital while still being safely monitored as frequently as they need, depending on their treatment,” Lindsey Zinck, chief nursing officer for the Abramson Cancer Center at Penn Medicine, said in an email.

The center, which first opened in 2016, extended its weekday hours and offered weekend visits in 2024. After seeing good results in terms of patients avoiding ER visits, it became available around the clock.

“We increasingly saw our patients needing transfusions on the weekend, after-hours care that couldn’t wait for the next day,” Zinck said. “Our emergency department does a wonderful job for emergencies, but sometimes our patients need care that can’t wait for clinic hours and doesn’t need an inpatient stay.”

Why oncology urgent care

Oncology urgent care clinics have been in operation for more than a decade, gradually expanding to meet the growing needs of this patient population.

“As the care gets more complex, we have to kind of adapt to that complexity of care,” Christopher D’Avella, a faculty member at the Penn Center for Cancer Care Innovation in Philadelphia, said.

D’Avella said that as the traditional arsenal of treatments for cancer, such as chemotherapy, radiation therapy and surgery, is expanded with options like immunotherapy, which trains the immune system to attack cancer cells, patients may experience new and possibly more severe side effects during the course of their treatments.

In the case of immunotherapy, patients can experience side effects such as cold and flu symptoms, but in more severe cases, patients can develop inflammation in the lungs or intestines. D’Avella said there needs to be a place where patients can be watched carefully as side effects become worrisome.

Other factors that contributed to the growth in oncology urgent care were unnecessary ER visits and hospital admissions in the cancer patient population.

But even though these centers don’t operate exactly like typical urgent care centers; they’re still making patient care fast and efficient.

Temple University’s Fox Chase Cancer Center’s clinic, which opened in 2011, is called the Direct Referral Unit. Kristin Manley, the clinical director of the Hospitals Program at the Fox Chase Cancer Center, said patients are directed to call the DRU line and report their symptoms to a nurse. That provider either asks the patient to come in, stay home or go to the emergency room if the situation is dire.

Manley said this process prevents long waits, usually ensures that patients are seen immediately when they come into the unit and gives the staff a better understanding of how to treat the patient when they arrive.

“We’re able to narrow down what our top three things that could be causing this … definitely a much shorter list for us than if you were going to an emergency room,” she said. “And hopefully our goal is to get our patients’ symptoms under control, whatever brought them in, and get them home that same day.”