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.
DVTs are a little discussed complication suffered by cancer survivors, including men treated for prostate cancer.
According to the Coalition to Prevent DVT, 2 million Americans experience a DVT each year, and up to 300,000 of them die when a fragment breaks off and moves to the lungs and blocks a pulmonary artery.
Most people who know about DVTs think that only older people with poor blood circulation need worry about blood clotting. However, cancer can alter the blood’s clotting activity and greatly increases the potential for DVTs.
Cancer often changes the blood’s coagulation properties and puts cancer patients at greater risk of developing blood clots. One study showed that cancer patients were four times more likely than the non-cancerous population to develop a DVT (Venous Thromoembolism and Cancer: Risks and Outcomes, 2003).
Some of the cancers in which there has been an association with abnormal clotting activity include stomach, renal, ovarian, lunch, brain, pancreatic, liver, gallbladder, colon, breast, cervical and prostate cancer.
Additional increased risk factors for developing DVTs include trauma, prior DVT, obesity, pregnancy, advanced age, smoking, immobility, use of oral contraceptives and restricted mobility caused by long-distance air travel.
A regimen of 3-6 months on Warfarin, a blood thinner, is often prescribed to treat DVT. Warfarin only thins the blood, it doesn’t dissolve the clot. A natural tPA and plasinogen in the blood flows over the surface of the clot to dissolve it naturally. As long as the clot is only partially occluding the vein – as opposed to a full occlusion or blockage – blood will most likely slowly dissolve the clot over time. Additionally, compression socks are also worn.
The actual goal of treating the DVT is to:
* Stop the clot from getting bigger.
* Prevent the clot from breaking off and traveling to your lungs.
* Prevent any future blood clots.
The most important question is what can you do to prevent DVTs?
* Frequently exercise your lower leg muscles if you’ll be inactive for
a long period of time.
* Get out of bed and move around as soon as you can after having surgery or being ill.
* After some types of surgery, take medicine to prevent blood clots as directed by your doctor.
How do I know if I have a DVT?
Some people have no symptoms, but most have some swelling in one or both legs. The swelling can be accompanied with pain or tenderness in one leg (may happen only when you stand or walk). You also may also notice warmth, or red or discolored skin in the affected leg. If you have any of these symptoms, call your doctor right away.
How are DVTs diagnosed?
There are usually two tests that can be run to see if you have a DVT. An ultrasound which uses sound waves to check the blood flow in the veins is one. The other is a venography where dye is injected into your vein and then an x-ray is taken to look for blood clots.
Having cancer, including prostate cancer increases your risk for deep vein thrombosis. DVTs can be dangerous and need to be treated immediately. If you think that you might have one call your doctor immediate or go to an emergency room.
Joel T Nowak MA, MSW
I have prostate cancer and recently was diagnosed with a PE (pulmonary embolism). My blood pressure was 120/80, no symptoms, I felt fine. I had just completed a trip from Thailand by air about 4 days prior. There was no swelling of the legs, I had a sonogram ultrasound and nothing showed up.
Reading this article was very interesting because my General Practitioner said the PCa prostate cancer could have caused the PE. Then I read your article, which my cousin found.
My question is this: I was diagnosed 10 years ago, but no surgery or radiation yet. Only one year of ADT which ended 2 years ago. So my question is you say, “including men treated for prostate cancer”. Does this mean only men with surgery or radiation?
I saw your booth at the PCRI seminar in September. I think I met you in person there. I recall the face.
Thanks for any information you have.
Tex US TOO, Houston
(currently living in Thailand)
No, having prostate cancer itself increases the risks of developing DVTs.
Hello Joel: My name is Teresa Sewell, I am from Talladega, Ala. I am writing to you on behalf of my husband. My husband was diagnosed with intermediate prostate cancer in late March 2016 he had 2 biopsies which showed he had 2 lesions on his prostate that were malignant we were told about the different treatment options available. My father had been diagnosed with prostate cancer 2 years earlier and had chosen EBRT and he was 80 years old at the time my father did fantastic with the EBRT treatment no fatigue, pain or anything he continued to go about his normal activities every day so my husband and I also chose EBRT but I did tell the oncology radiologist that my husband did have 1 knee replacement and 2 total hip replacements which were done in 2011 and 2013-2014 he was give Xarelto after each hip replacement. Well it took about a month before there was an opening for my husband to start the EBRT treatments so we began sometime around the beginning to middle of April 2016 it consisted of us traveling about 65-70 miles each day to Birmingham, Ala for treatments which lasted about 20 minutes for each treatment for 8 weeks during the 8 weeks we were asked to stay over after the treatment had ended to speak with the radiologist this was done every Thursday well everything went along fine for weeks 1-4 on week 4 my husband began experiencing shortness of breath and fatigue we were told that fatigue was to be expected when we told the radiologist about the shortness of breath he did not listen to my husband’s chest or order any type of blood tests or scans or anything he said the shortness of breath was caused by the extremely hot weather we were having here in Alabama I told the doctor that I seriously doubted that was the cause because my husband had recently had to go on disability due to not being able to stand on concrete floors for long periods of time but when he was able to work he worked for 23 years in a foundry next to a furnace which was very hot environment the workers that were under him told me that they did not see how the heat from the furnace did not affect him he just continued to work through the heat he then went to work for an auto manufacturer on one of the heaviest jobs on the assembly line and he would come home with is work clothes wet like he had been standing out in the rain he was a very hairy man but the heat did not seem to bother him, when he began experiencing the shortness of breath he was helping my oldest son on our farm he mainly drove the John Deere tractor so we accepted that it might be the heat well the next Thursday rolled around and the shortness of breath was worse and the fatigue was worse the doctor once again did not testing and he continued to blame it on the hot weather this went on for weeks 4-8 of the treatments my husband received a I Survived cap and was told to go home and wait for 1 month he was still having shortness of breath and fatigue when we went home he thought the shortness of breath would go away since he was not having treatments every day but it did not improve at all. To give you an example of how bad the shortness of breath was on July 22, 2016 we celebrated our younger son’s birthday at a restaurant and I parked my car almost directly in the front door when we got ready to leave the restaurant he asked me to move the car closer to the door because he didn’t think he could make it across the parking lot I moved the car closer and tried to get my husband to let me take him to the hospital because this was late on a Saturday night but he refused because he was to go back to the cancer radiologist the following Monday to have blood work drawn which on Monday July 25,2016 we returned to the office he did not meet with the radiologist he only went to the lab to have blood drawn we were told to come back to the office on July 28, 2016 for the results of the bloodwork and to talk to the radiologist well my husband did not make it back for his follow up appointment because he died of cardiac arrest on July 27, 2016 my husband never had any type of cardiac problems at all he was a healthy man except for having diabetes and being overweight before he was diagnosed with prostate cancer he was never sick at all well as you can imagine my entire family were in shock the ER doctor that pronounced my husband dead asked me and my oldest son what had happened we told him that he had just gotten out of the bathtub and was getting dressed when we heard him fall we thought he might have fallen in some water or something when I ran to the bedroom he was on the floor semi conscious I told my son to call 911 and tell them he was having a heart attack my son had previously worked with the fire dept. so he knew how to do CPR and he began CPR it took the ambulance it seemed like forever to get to my house they came in my son had got my husband to begin breathing again he had stopped breathing twice before the ambulance arrived they come into the bedroom they hooked him up to something that looked like an EKG machine and they put the thing in his index finger which monitors oxygen level once EMT looked at the tape from the machine my husband begin to speak the EMT’s took his blood sugar level which was fine they took his blood pressure which was good they proceeded to sit my husband up into a sitting position he was telling them he did not need to go to the hospital but I told the EMT’s that he was going to the hospital so they proceeded to get my husband on to a sheet so that they could lift him my husband weighed around 260 lbs and both of the EMT’s together probably did not weigh 260 lbs they did not ask my father or my son to help assist them with lifting my husband on to the stretcher they both lifted him when the started up the hallway of my home my husband begin yelling that he could not breath he yelled this twice when they got outside of my house my mother, father and my youngest son were in the yard my dad saw the minute my husband died because his arm went limp the EMT’s did not get in any hurry to get him into the ambulance but once they did get him into the ambulance the ambulance begin bouncing up and down they were giving him CPR again and administering epinephrine and oxygen which did no good after several minutes the ambulance left my house with no sirens going and not driving fast at all when we got to the hospital we were told my the ER doctor that my husband had died and he asked what had been going on with my husband I told him that he had recently finished EBRT for prostate cancer and had been experiencing shortness of breath and fatigue he asked what the cancer doctor had been doing for the shortness of breath and I told him absolutely nothing he said it was due to the hot weather the ER doctor said no that the shortness of breath was probably caused by several small blood clots in his lungs and that a d-Dimer blood test would have shown this along with a Doppler scan to check for DVTs in his legs he suspected when the EMT’s moved my husband on to the stretcher they got the blood clots in his legs to moving and they went to his lungs and heart. My husban’s primary doctor also told me that my husband’s death was entirely preventable and that I should consider filing a negligence lawsuit which I have retained legal representation and they are waiting for a COMPLETE set of medical records from his doctors the reason they know they are not receiving a complete set of records is because after the funeral I asked the doctors for his medical records and I knew the doctor’s notes were missing so I drove back to the doctor’s office and asked for the doctors notes which shows on 6/9/16 which was a Thursday during the 8 weeks that the doctor noted that we told him about the shortness of breath he made a note of this and put an asterick by it and circled the asterick which in my opinion would be done to draw the doctor’s attention to this but he still did not order any testing to be done at all. At this time my attorneys are working to see if we have a case or not. I would appreciate what you think about what happened to my husband. Thanks for listening.
I would like to know if you think I have a legal case since no autopsy was performed?