Would you offer palliative radiation therapy for bleeding risk reduction in a patient with large vessel invasion from an intrathoracic tumor who requires anticoagulation?  

Hi. Based on what you present here..."Exsanguinate" comes to mind for me in this instance. I can recall one lung ca patient who had such a final event early in my career. And I have seen some in-patients with advanced Head Neck cancers go out that route. It can be quite disturbing to some / unsight...