On July 23, 2008 I wrote an article on deep vein thrombosis (DVT), a hidden danger for men with prostate cancer.

Studies show more than 90 percent of patients with cancer may experience an increase in the blood’s clotting activity, which can lead to a Deep Vein Thrombosis, or DVTs. DVTs can be a life threatening complication which a majority of cancer survivors will face as they wend their way through treatment.

DVT occurs when a blood clot develops in the veins of extremities, usually the lower leg or thigh and sometimes the arm. It can be a hidden complication, but usually causes significant pain and swelling. In addition to the pain, If not treated, a DVT can lead to a pulmonary embolism, which can be fatal if the clot breaks free and travels to the lungs (pulmonary embolism).

A recent study has shown that combining short periods of leg compression along with medications such as heparin is more effective at preventing blood clots than using either of these standard preventative measures alone. A team of Cochrane Researchers believe that this ‘belt and braces’ approach can significantly decrease a patient’s risk of deep vein thrombosis (DVT).

DVTs are also a problem for people who sit in cramped conditions (e.g. economy class syndrome), they are much more common in patients undergoing surgery, people hospitalized with severe illnesses or with leg fractures as well as men with prostate cancer.

Anticoagulant medications such as heparin are used to thin the blood, as preventative measures for patients at high risk of DVT. Alternatively, using a pump to inflate an airtight bag around the leg is commonly used to prevent blood “pooling” and reduce the risk.

By analyzing data from eleven trials involving 7,431 patients, Cochrane Researchers found that a combined approach to prevention reduced the risk of DVT from 4 in 100 to less than 1 in 100 when compared to anticoagulants alone. When compared to compression alone, the risk of DVT was reduced from 4 in 100 to 1 in 100.

“Our results support guidelines that already recommend the combined use of medication and leg compression to prevent deep vein blood clots,” says lead researcher, Stavros Kakkos of the Henry Ford Hospital in Detroit, Michigan.

Despite this decrease of clots, there remain some questions as to whether the combined approach reduces a patient’s risk of a life-threatening pulmonary embolism caused by a clot traveling to the lungs.

Until additional research is preformed to determine if combining both drugs and the pump will actually save lives, it is my very strong recommendation is that you ask your doctor use both preventive measures when you are hospitalized. There is no increased risk to using both treatments (using a blood thinner does have some inherent risks) while there is a possibility that it might prove to be live saving.

Joel T Nowak MA,