Superior Vena Cava Obstruction

Lung cancer, particularly those in the right upper lobe of the lung can sometimes block a large vein that carries blood from the brain, head and arms back to the heart.  The vein is called Superior Vena cava, and when is it blocked or squashed it is called an obstruction (SVCO). This causes a build of pressure so that fluid seeps out of the blood stream and collects in the tissues.

Signs

The symptoms that patients may experience can be very distressing, they can develop gradually or happen very quickly and could include:

· Increasing breathlessness

· Swollen arms, neck and face, particularly around the eyes

· Purple dilated veins on the surface of the chest, neck and upper arms

· Headaches or fullness in the head, particularly on bending or lying down

· Dizziness

. Visual changes

Management

Treatments are aimed at reducing the blockage of the vein and reducing the symptoms.

• This condition should be fully assessed by the lung cancer team, including an oncologist.

• High dose steroids can be given to help to reduce tumour swelling.

• Appropriate pain killers for the headache, and any pain.

• Oxygen may be required when the oxygen saturation reading is low.

• Sometimes a stent can be inserted to try to keep the vein open.

• Other treatments depend on the type of lung cancer you have, and may include radiotherapy and chemotherapy.

References;

Fallon, M. Hanks, G (2006)  ABC of palliative Care, Second Edition. Blackwell, Oxford

Watson et al.  (2009)  Oxford Handbook of Palliative Care Second Edition. Oxford University Press, Oxford

http://www.macmillan.org.uk/Cancerinformation/Livingwithandaftercancer/Symptomssideeffects/Othersymptomssideeffects/Superiorvenacavaobstruction.aspx