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Blood Clots: What Cancer Patients Need to Know

By April 3, 2019No Comments

When Don Stranathan’s left leg became swollen after a long day of shoveling granite for a buddy’s new bocce ball court, he didn’t think much of it. He even joked about it on Facebook.

“Typical me, I posted a pic and said, ‘I worked so hard, my leg’s all swollen,’” said the 66-year-old metastatic lung cancer patient from Santa Rosa, California. “Then somebody said, ‘Don, if you have lung cancer, there’s a good chance that could be DVT, deep vein thrombosis. You should get that checked; it could be serious.’”

As it turned out, it was serious — and not just for Stranathan. Blood clots, also known as thrombi, or, when they break loose and lodge in the lung, venous thromboembolisms, are the next leading cause of death in cancer patients after cancer itself. They are a side effect of both treatment and the biological nature of the disease. Cancer thickens the blood, releasing substances that make it “sticky” so clots form more easily, and treatment can exacerbate the risk. Surgeries immobilize patients, chemotherapy inflames the blood vessels and veins, and the blood becomes clogged with bits of dead cancer cells. In addition, anti-hormone therapies like Tamoxifen or targeted therapies like Avastin are known to encourage blood thickening or hypercoagulability.

Five to 25 percent of cancer patients (particularly those with metastatic disease) get blood clots. Not all of them go on to wreak havoc, but many do result in hospitalizations, pain and suffering, and even death, as well as, of course, high health care costs. A 2018 study found cancer patients who developed a venous thromboembolism, or VTE, while hospitalized had an average cost of $37,352, with an average length of stay of more than 12 days, compared to patients without VTEs who had average costs of $19,994 and spent about a week in the hospital.