26th February 2025

A 74-year-old woman with metastatic lung adenocarcinoma presents with superior vena cava obstruction

A 74-year-old woman with metastatic lung adenocarcinoma presents with superior vena cava obstruction that is causing facial plethora and breathlessness. She is struggling to lift her arms above her head when showering and dressing and struggling to tie her shoelaces as this worsens her symptoms. She had been receiving treatment with chemotherapy and immunotherapy until a few weeks ago, and before this, she had multiple courses of radiotherapy to her chest and neck. She tells you she stopped systemic anti-cancer treatment due to further metastatic spread and treatment side effects as she has decided that she wants to focus on quality of life and symptom control. She has been told her life expectancy may be short weeks to short months.

What would be the most appropriate management strategy to relieve this patient’s superior vena cava obstruction?

Select the SINGLE most appropriate option from the list below. Select ONE option only.