Oncological emergencies (except neutropenic sepsis!) Spinal cord compression

Surgery for cord compression

• Improvements in pain in 75-100%.

• Improvements in neurology in 50-75%.after surgery.

Chemotherapy

• In theory can be used for the very sensitive tumours:

• Lymphoma.
• Teratoma.
• SCLC (maybe).

• However, in view of devastating effects of neurological deterioration practice is often to treat small RT field (reduce bone marrow suppression) then move to chemotherapy.

Conclusions

• Common, often unrecognised with serious impact on patients’ quality of dying.

• RADICULAR PAIN =

• CORD COMPRESSION!

• Needs steroids and URGENT MRI!

Superior vena cava obstruction

Superior Vena Cava Obstruction

• Obstruction of blood flow through the SVC

Superior Vena Cava Obstruction

• CAUSES:

• Lung Cancer* 80%

• Lymphoma 10%

• Other Malignancy 5%

• Benign causes 5%

• (e.g. aneurysm, goitre, fibrosis, infection etc.)

• Occurs in 10% SCLC cases and 1.7% of NSCLC cases