Oncologic Emergencies Dr Karenza Alexis

Superior Vena Cava Syndrome

• Treatment

• Goal: alleviate symptoms and treat underlying disease

• Initial management depends on Grade of SVCS, underlying disease, anticipated resposbse

• Determine underlying cause- especially if SVCS is presenting symptom
• Pace of progression of symptoms
• Treatment goal- Cure vs Palliation

Superior Vena Cava Syndrome

• Treatment

• Symptom management: Elevation of head of bed, O2, bed rest
• Radiotherapy
• Cure vs Palliation
• Accurate histologic diagnosis needed prior
• EMERGENT RT needed if life-threatening symptoms/signs (stridor/ CNS symptoms from cerebral edema)
• If Non-small cell lung cancer
• Combine with chemotherapy if limited stage small cell lung cancer and Non- Hodgkin’s lymphoma
• Stenting for life threatening symptoms especially in tumors not sensitive to chemotherapy or radiation or no diagnosis of cancer
• Chemotherapy
• Lymphoma or germ cell tumor or small cell lung cancer
• Consider thrombolysis, angioplasty if thrombosis
• Diuretics- transient, may cause dehydration and reduced blood flow
• Steroids