These can be broadly classified into following groups. Pressure or obstruction caused by a space occupying lesion, metabolic changes or hormonal problems (Para neo-plastic syndromes) and the complications arising from the effects of treatment. SVCS is the clinical expression of obstruction of blood flow through the SVC, usually manifested as facial edema and plethora, dilatation of chest wall and neck veins, dyspnoea, sometimes CNS symptoms and visual disturbances. Clinical presentation of SVC obstruction has insidious course and usually present with dyspnoea; fullness in the head, facial swelling, cough, chest pain, arm swelling, vemous distension of neck and chest wall, dysphagia and less frequently stridor, upper body cyanosis, neurological symptoms in the form of headache and lethargy. CT Scan-Provides more detailed information about the SVC its tributaries and other mediastinal structures. Contrast enhanced CT gives information of intravascular and extravascular tumour as well as thrombus formation within the SVC. During the diagnostic process, patient can be benefited from bed rest, head end elevation, and oxygen administration. Diuretics are thought to lessen edema but without clear evidence of efficacy. Steroids (Dexamethasone 10 mg 6 hourly) are also advocated by few with no clear benefit. Radiotherapy: Administration of radiation is either disease specific after the establishment of diagnosis or sometimes also used as an effective initial treatment if histologic diagnosis cannot be established and the clinical status of patient is deteriorating. In adults massive hemoptysis is the expectoration of 600 ml of blood in 24 hours and is usually caused by non-malignant conditions. It may develop in older patients with lung cancer or lung metastases in presence of coagulation defects or thrombocytopenia. As the clots in airways may asphyxiate the patient, hemoptysis should be treated emergently. Therapeutic objectives are to prevent asphyxiation, localize the site of the bleeding and arrest the hemorrhage. Tumour lysis syndrome is a constellation of metabolic abnormalities resulting from cancer cell death. Tumour cell lysis either spontaneous or chemotherapy induced results in release of intracellular contents at a rate that exceeds the kidney’s capacity to clear them leading to accumulation of liberated substance in the body. The patients of TLS may present with asymptomatic laboratories abnormalities; Cardiac arrhythmia and arrest (Due to Hyperkalemia); Neuromuscular irritability, Tetany, Seizures, Mental status changes (Hypocalcemia); Acute renal failure (Hyperuricemia and Hyperphosphatemia); Metabolic acidosis (Lactic acidosis and Acute renal failure). Certain preventive measures should be taken before starting chemotherapy to reduce the onset and severity of TLS. Vigrous and adequate hydration; start of allopurinol therapy. Oral phosphate binders beginning 24 hours before the administration of chemotherapy. Hypercalcemia is the most common paraneoplastic syndrome and one of the most common metabolic complications of malignancy. It occurs in approximately 10% of patients of cancer. Common tumours associated with hypercalcemia are Lung-35%; Breast-25% Hematologic (Myeloma, Lymphoma)-14%. Conservative management—asymptomatic patients; Serum Calcium < 3.25 mmol/L. Aggressive management—all symptomatic patients; serum calcium > 3.25 mmol/L. Hyponatremia is commonly defined as serum sodium < 130 mEq/L, and the reported incidence is <5% in the hospitalized cancer patients. Clinical manifestations—asymptomatic, impaired conciousness, coma, generalized hypotonia, seizures, anorexia, nausea and asthenia. Plasma osmolality and serum sodium estimation. Sodium deficit calculated by the formula: [Desired Na-Measured Na] × 0.6 Body weight (Kg) = mEq of Na needed. Spinal cord compression is the second most common neurological emergencies in cancer patients occurring in 5–10% of the cancer patients. The common malignancies responsible for this condition are multiple myeloma, prostate cancer, nasopharyngeal cancer, breast cancer, lung cancer and lymphoma. The most common site of involvement is thoracic spine followed by lumbar spine.