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