Faculty Collaboration Database

Bleeding in cancer patients and its treatment: a review. Ann Palliat Med 2018 Apr;7(2):265-273

Date

01/09/2018

Pubmed ID

29307210

DOI

10.21037/apm.2017.11.01

Scopus ID

2-s2.0-85046366166 (requires institutional sign-in at Scopus site)   138 Citations

Abstract

Bleeding is a common problem in cancer patients, related to local tumor invasion, tumor angiogenesis, systemic effects of the cancer, or anti-cancer treatments. Existing bleeds can also be exacerbated by medications such as bevacizumab, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticoagulants. Patients may develop acute catastrophic bleeding, episodic major bleeding, or low-volume oozing. Bleeding may present as bruising, petechiae, epistaxis, hemoptysis, hematemesis, hematochezia, melena, hematuria, or vaginal bleeding. Therapeutic intervention for bleeding should start by establishing goals of care, and treatment choice should be guided by life expectancy and quality of life. Careful thought should be given to discontinuation of medications and reversal of anticoagulation. Interventions to stop or slow bleeding may include systemic agents or transfusion of blood products. Noninvasive local treatment options include applied pressure, dressings, packing, and radiation therapy. Invasive local treatments include percutaneous embolization, endoscopic procedures, and surgical treatment.

Author List

Johnstone C, Rich SE

Author

Candice A. Johnstone MD, MPH Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bandages
Embolization, Therapeutic
Endoscopy
Female
Hemorrhage
Humans
Male
Neoplasms
Radiotherapy