Does Cancer increase risk of Thrombosis? Here are 5 things you should know

Cancer and sometimes its treatment can result in blood clotting changes or blood vessel damage in your body. People fear that this can increase the risk of thrombosis that occurs in both arteries and veins. Dr Roopen Arya, Professor of Thrombosis and Haemostasis at King’s College Hospital, London offers us a deeper insight into the subject so you may gauge the true risk of thrombosis.

Updated on Dec 15, 2021 06:56 PM IST  |  433.3K
health,cancer,Health & Fitness,risk of Thrombosis
Does Cancer increase risk of Thrombosis? Here are 5 things you should know
Remove Ad X
Advertisement

Cancer and sometimes its treatment can result in blood clotting changes or blood vessel damage in your body. People fear that this can increase the risk of thrombosis that occurs in both arteries and veins. Dr Roopen Arya, Professor of Thrombosis and Haemostasis at King’s College Hospital, London offers us a deeper insight into the subject so you may gauge the true risk of thrombosis.

  1. Does cancer cause thrombosis?

Cancer is strongly linked to blood clots. Venous clots are more common, termed venous thromboembolism or VTE which includes deep vein thrombosis (DVT) in the limbs and pulmonary embolism (PE) in the lungs. In order to ascertain the risk of thrombosis, you must factor in aspects like old age, obesity or previous history of VTE in combination with factors related to cancer and its treatment.

About one in six cancer patients develop VTE and VTE is the second most common cause of death in cancer patients after the cancer itself.

cancer and thrombosis

  1. Who is at most risk?

Cancer of the pancreas, brain and stomach are considered higher risk for thrombosis and breast and prostate relatively less so. More advanced stage of cancer or cancer that has spread also carries a higher risk of clots. Cancer treatment can also increase risk of clots whether due to hospitalization, surgery, central venous catheters or anti-cancer drugs. Certain chemotherapies such as platinum-based agents are higher risk as are drugs that modify the immune system such as thalidomide. Drugs that affect hormone receptors such as tamoxifen used for breast cancer can also increase risk.

  1. Warning signs to look out for

Nearly 1 in 10 VTE events are related to cancer, so it is important that doctors looking after the VTE patient are vigilant and screen for cancer if there are suspicious features especially in older patients.

  • DVT usually affects the legs causing leg swelling, warmth and tenderness though sometimes there are very few symptoms.
  • DVT can also affect the arm, particularly in breast cancer or typically in thrombosis related to central venous catheters. Blood clot might break off from the DVT and travel to the lungs, causing PE.
  • Patients with PE typically present with breathlessness and/or chest pain and sometimes with coughing up blood.

cancer and thrombosis risk

  1. How can blood clots be avoided?

When cancer patients are hospitalized, thrombosis risk is further increased. This risk is reduced by putting patients on injections of a blood thinner called low-molecular-weight heparin (LMWH). These injections are usually given into the skin of the tummy once a day while in hospital. In some cases, particularly after major cancer surgery the injections can be given for a few weeks after discharge to further reduce the risk of VTE.

Generally, cancer patients at home do not need blood thinners for blood clot prevention but selected cases might benefit from this approach.  Recent studies show that oral blood thinners called direct oral anticoagulants (DOACs) might be used to prevent VTE in selected high-risk cancer patients at home.

  1. Treatment options

In recent years LMWH injections (typically enoxaparin or dalteparin) have been the main treatment for cancer associated thrombosis because they are superior to traditional oral treatment with warfarin. LMWH is better absorbed and there are minimal interactions with anticancer treatment. Newer studies have shown that the oral DOAC drugs such as edoxaban, rivaroxaban or apixaban are safe and effective in selected patients with cancer associated thrombosis.

Hence the treatment of thrombosis in cancer patients now often starts with LMWH with the possibility of later switching to a tablet. Usually VTE is treated with 3 to 6 months of anticoagulation but in cancer patients this period is extended if the cancer is still active.

Also Read: A nifty guide on how to stop hair loss and regrow hair naturally

Remove Ad X
Remove Ad X
Advertisement

Top Comments
There are no comments in this article yet. Be first to post one!