Cancer and Blood Clots: Three Things You Need to Know
Receiving a cancer diagnosis is life-altering. In addition to starting treatment and planning a course of care, cancer patients may be surprised to learn they must also think about thrombosis, commonly known as blood clots.
It’s a startling fact that people with cancer are four times more likely than the general population to develop a serious blood clot. More specifically, cancer raises a patient's risk for deep vein thrombosis (DVT), a blood clot often found in the leg, pelvis, or arms, which can move through the body and lodge itself in the lungs, becoming a pulmonary embolism (PE). Together, DVT and PE are known as venous thromboembolism (VTE) — a dangerous and potentially deadly medical condition.
It’s important for cancer patients to know the risk factors, signs, and symptoms of VTE and take preventive measures.
1. Certain Cancers Have a Higher Risk
For reasons that remain unclear, certain types of cancer are associated with a higher risk for VTE. Cancers of the lungs, brain, kidneys, ovaries, and pancreas, and lymphoma blood cancers have all been connected with a higher risk for blood clots. While patients with these types of cancer are at higher risk, all cancer patients should be aware of the causes and dangers of VTE to avoid complications.
2. Surgery Increases Risk
Surgery can often be lifesaving in the battle against cancer. Unfortunately, it also increases the threat of VTE. While the incidence of VTE is considerably higher in cancer patients who have surgery, recent studies indicate that patients who are older or who have obesity are also at risk.
Surgery often leaves patients inactive for an extended time, both during the hospital stay and afterward in the recovery period. Anytime someone is inactive for a long time, the risk of a clot rises. Additionally, surgery can damage the blood vessel walls, drastically affecting the way blood flows through the body and increasing the chances a clot will form.
3. Chemotherapy and Hormone Therapy Can Increase Risk
Similar to surgery, chemotherapy can leave patients inactive for weeks or months, increasing the chance of VTE. Chemotherapy itself can also increase the risk. As chemotherapy kills cancer cells, substances may be released into the bloodstream that increase clotting. Not all chemotherapy drugs are the same, though, and some are less likely to cause clotting than others.
Some cancer treatment plans involve hormone treatments, which can interfere with the body’s estrogen level, thickening the blood and allowing clots to form. Specifically, hormone therapy can increase the risk of VTE in patients with breast cancer.
Patients are encouraged to ask their healthcare providers about the risks associated with each type of chemotherapy and to keep their healthcare provider informed of any previous conditions associated with VTE, such as obesity or a prior VTE.
Taking Steps to Prevent VTE
While research shows that cancer raises the risk of VTE in patients, there are steps that can be taken to prevent a clot. Patients should talk to their doctors about starting low-dose anticoagulant (blood-thinning) medications to keep clots from forming. During treatments, patients can wear compression socks to massage the legs and keep blood flowing.
Going for short walks and doing leg exercises along with stretches can help promote healthy blood flow as well. These exercises can be as simple as getting up once an hour to march in place for one minute. Heart healthy nutrition is also important.
Everyone should learn the signs of a blood clot, and the risk factors that can cause them, but it is especially important for patients with cancer and their loved ones. The most important tool in preventing a fatal complication is knowledge and awareness.
For more information on blood clots and their complications, visit WorldThrombosisDay.org.
Mary Cushman, MD, is a hematologist at the University of Vermont Medical Center in Burlington, where she is the medical director of the Thrombosis and Hemostasis Program. Dr. Cushman is also a professor of medicine and pathology at the Larner College of Medicine at the University of Vermont Medical Center in Burlington. She is the editor in chief of Research and Practice in Thrombosis and Haemostasis, an open-access scientific journal of the International Society on Thrombosis and Haemostasis (ISTH).
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