The abscopal effect is a phenomenon that describes the systemic antitumor response that can occur as a result of a localized radiotherapy. Although sporadic cases of abscopal effect have been reported since 1960's, the number of reported cases are significantly increasing in the immunotherapy era. Immunotherapy seems to enhance the immunogenic effects of radiotherapy, thus increasing systemic antitumor response. Although combination of radiotherapy and immunotherapy is a promising strategy in the treatment of metastatic cancers, many questions regarding the optimal treatment remain unanswered. Increasing number of ongoing studies will hopefully provide answers to these questions, enabling the utilization of this strategy in systemic anticancer treatment.

Pregnancy-associated breast cancer is a diffi cult psychosocial and health problem for the patient, demanding an individual multidisciplinary treatment approach. Due to the need for aggressive oncological treatment with minimal adverse eff ects on the growing fetus, numerous studies are carried out to fi nd an optimal protocol, concerning the interest of both the mother and the child. Due to the physiological changes in the breasts in pregnancy, the diagnosis of breast cancer can be delayed and therefore patients have often higher clinical stage of the disease at initial presentation comparing to non-pregnant patients. Pregnancy termination due to breast cancer diagnosis had no eff ect on the prognosis of the patient, and longterm studies did not fi nd a higher incidence of malignant disease in children who were exposed to chemotherapy in utero compared to the general population. Although prognosis data of those patients is controversial, recent studies have not found a worse outcome compared to breast cancer unrelated to pregnancy.

For the past several decades, we have witnessed the emergence of the obesity pandemic worldwide and, simultaneously, the increase of incidence of malignant diseases. The effects of obesity and overweight on cancer incidence, morbidity, and mortality started to be meticulously researched only recently. According to the epidemiological data analysis, the connection between obesity and increased risk of numerous cancers has been established. Estimations are that a change in lifestyle and diet can prevent 30-50% of malignant diseases. After smoking, obesity is the second largest preventable cause of cancer. Obesity affects the quality of life and increases the risk of cancer recurrence and cancer-related mortality. By reducing body mass and avoiding gaining weight during adulthood, the risk of getting cancer is lowered. Numerous studies have shown the beneficial effects of physical activity during and after cancer treatment. Obesity influences cancer development; however, the mechanisms responsible for it are still unclear. It is considered that chronic inflammation, caused by the overabundance of nutrients, increases the levels of inflammatory cytokines and immune cells. It has been discovered that adipocytes have an important endocrine role; they synthesize numerous hormones and adipocytokines, such as leptin and adiponectin. High levels of leptons and low levels of adiponectin can activate intracellular signaling pathways involving malignant cells’ development. An important part of cancer development can be attributed to insulin metabolism, insulin-like growth factors, and sex hormones.

Cancer of an unknown primary site is most commonly an aggressive metastatic tumor with a median patient survival of 6 to 9 months. Histologically, it is predominantly adenocarcinoma, and if the primary site is subsequently diagnosed, it is usually the pancreas or lung. Biopsy should be performed whenever possible to classify a tumor of unknown primary origin into one of the following entities: adenocarcinoma, poorly differentiated carcinoma with characteristics similar to adenocarcinoma, squamous cell carcinoma, neuroendocrine carcinoma, poorly differentiated neoplasm. After determining the primary tumor type, the subtype is determined by immunohistochemical staining. In oligometastatic disease, there is a possibility of surgical treatment. Radiotherapy is used as a part of combined modality treatment. Most patients with cancer of unknown primary have an unfavorable prognosis despite multiple chemotherapy agents, and no protocol can be recommended as standard therapy.

Emergency conditions in oncology may arise either as part of the malignant disease itself, or may be associated with its treatment. They are potentially life-threatening conditions that require urgent care, often with patient hospitalization and a multidisciplinary treatment approach. Consequently, it is important that all physicians are familiar not only with potential oncological emergencies which may occur in their clinical practice but also how to provide the most effective care in a timely fashion. In this review article we comprise the clinical features and treatment of several of these emergencies, namely the superior vena cava syndrome (SVCS), elevated intracranial pressure, metastatic spinal cord compression (MSCC), hypercalcemia and febrile neutropenia.