Uncontrolled Tumour Haemorrhage

Clinical Description

• Occurs following tumour erosion into a blood vessel or any trauma to tumours in any part of the body.

Signs and Symptoms

• Presence of known malignancy
• History of bleeding or persistent obvious bleeding
• Symptomatic anaemia
• Hypovolaemic Shock

Treatment

Volume support

• Secure IV access
• IV Fluids (isotonic vs. colloids vs. blood products) depending on presentation

Control bleeding

• IV Tranexamic acid 500 – 1000 mg 8 hourly
• Adrenaline pack or simple pressure pack; including vaginal pack for cervical cancer
• Suture or cauterize an obviously bleeding blood vessel
• For internal tumours: consider surgical referral or interventional radiology referral for vessel embolization
• Definitive or Palliative treatment: Chemotherapy, Radiotherapy, Targeted therapy according to tumor histology and stage of disease