|
The
challenge of cancer and thromboembolic disease
Current trends and recommendations
Mary-Frances Scully, MD, FRCPC and
Agnes Y.Y. Lee, MD, MSc, FRCPC
|
To view the complete article click
here (pdf format)
It has been known for nearly 200 years
that people with cancer are more prone to venous thromboembolic disease
(VTE). The most common form of VTE is deep vein thrombosis (DVT),
which can lead to potentially fatal pulmonary embolus. Almost 20%
of all DVTs occur in people with cancer, and an estimated 10% of patients
presenting with unprovoked DVT are diagnosed with cancer within the
next few years. Arterial thrombotic events, including myocardial infarction
and thromboembolic stroke, also occur in cancer patients. VTE is more
common in certain types of cancer, especially multiple myeloma, other
hematologic malignancies, adenocarcinomas (especially of the pancreas,
ovary, colon, stomach, lung and kidney) and malignant brain tumours.
Other risk factors for VTE in cancer patients are advanced age, immobility,
having a central venous catheter, surgery and other cancer treatments
including radiation and some chemotherapeutic agents. VTE is difficult
to prevent, diagnose and treat in cancer patients. Anticoagulation
agents including warfarin, heparin and low-molecularweight heparin
can be given for prophylaxis of VTE, but these (especially warfarin)
are complicated to administer and may cause bleeding. Low-molecularweight
heparin prophylaxis should be considered in selected cancer patients
undergoing surgery and in those with multiple risk factors.
To view the complete article click
here (pdf format)
|
