Many people with cancer may not be aware of their risk for developing blood clots, especially during treatment. Blood clots, also called thromboembolisms, can develop in veins that carry blood to the heart. In some cases, these clots can break off and travel to the heart or lungs and block the flow of blood, causing a pulmonary embolism. A pulmonary embolism can be fatal, so it is crucial to be aware of your risk for developing clots, as well as signs and symptoms of blood clots.
Who is at risk?
The increased risk of developing blood clots is present whether you’ve been battling cancer for years, or are newly diagnosed. As many as 15% of people with lung cancer develop blood clots during treatment, regardless of how long they have had the condition. These risks are greater if a person has metastatic cancer, elevated white blood cell counts, anemia, a genetic predisposition to blood clotting, a history of blood clots, and/or the presence of lung adenocarcinoma. Your healthcare provider can test your blood to determine if you are at increased risk for developing clots.
While clots can occur for many reasons, they can also be linked to certain medications, like anti-angiogenic drugs, or erythropoiesis stimulating treatments that cause the body to make more red blood cells. Chemotherapy and radiation treatment for cancers such as lung, kidney, brain, digestive system, female reproductive system, and blood cancers, as well as metastatic cancers, can directly increase the risk. People are also at greater risk for developing blood clots if they are immobile for long periods of time, such as after a surgery or while in the hospital. In addition, older age, inherited blood conditions like sickle cell or blood clotting disorders, and certain race or ethnic characteristics are shown to increase the risk of clot development.
What are the symptoms?
Many clots begin as a deep vein thrombosis, or DVT. These are clots formed typically in the legs or major veins of the body. Pain in your calf, swelling/redness of one leg, sudden shortness of breath, and chest pain can all be signs of a DVT. It is important to recognize these signs and symptoms in order to seek the help you may need before a clot can travel to other parts of the body. It is estimated that as many as 78% of people who develop blood clots during treatment for cancer do so at home, and away from a hospital or clinic. Staying vigilant and looking for these warning signs may be more important now than ever before.
How can I reduce my risk?
Besides paying attention to the potential warning signs, you can also take steps to reduce your clot risk, especially during treatment. By moving around more and limiting the time you are immobile, like when in the hospital or on long trips, you can decrease your risk significantly. Additionally, it is important to discuss any potential risk factors for clots and what you can do to prevent clotting with your doctor. Some doctors may prescribe blood thinners to help prevent your blood from clotting. Blood thinners are often prescribed to people after major surgeries, when they may be recovering and unable to move around, but can be utilized at any time. These medications can also come with risks, such as an increased risk of bleeding. It is recommended to discuss the benefits and risks of blood thinners, along with your personal risk for blood clots, when making this decision with your health care team.
If you are worried about your potential risk of developing blood clots in conjunction with your lung cancer or cancer treatments, talk to your healthcare provider as soon as possible. Being vigilant and staying on top of this important issue is key!1-3
Falanga, Anna. “The Cancer-Thrombosis Connection.” The Hematologist, Ash News and Reports. 1 July 2011. Available from: http://www.hematology.org/Thehematologist/Mini-Review/1244.aspx
Powell, Samantha. “Blood Clots Common in People with Newly Diagnosed Lung Cancer.” Bonnie J. Addario Lung Cancer Foundation. 31 March 2014. Available from: https://www.lungcancerfoundation.org/2014/03/blood-clots-common-in-people-with-newly-diagnosed-lung-cancer/
“Preventing and Treating Blood Clots.” Cancer.net. 20 Jan 2015. Available from: http://www.cancer.net/research-and-advocacy/asco-care-and-treatment-recommendations-patients/preventing-and-treating-blood-clots