Cancer patients are frequently subject to non programmed access to the emergency department or to the oncological services. The main underlying needs are disease-related symptoms, treatment-related toxicity and end-of-life issues. Sudden events frequently change the trajectory of the disease and ask for rapid changes of cancer care. Hospital admission is frequently an unavoidable step in clinical history, especially in the last months of life. While an improvement in symptoms management and a tighter patients' control could prevent from the unexpected worsening of clinical conditions, oncologists and emergency physicians are called to a strict cooperation. Clinical informations availability, prompt symptom control, appropriate hospital admission or referral to a palliative care pathway are the key elements of a progress in the care of patients accessing the emergency departments.