10.8.3
Uncontrolled Tumour Haemorrhage
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 10, Oncology.
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
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