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When someone’s diagnosed with cancer, their doctor usually goes over the available treatment options. Often they include chemotherapy and radiation, both of which have a long list of side effects they make you aware of.
However, there are dangerous secondary conditions related to a lot of cancers that are often skimmed over during these briefings.
For instance, if you undergo a stem cell or bone marrow transplant, you’re at risk of graft-versus-host disease (GVHD), a condition where the donor cells recognize the host’s tissue as foreign and attack it. GVHD can be serious, especially if it involves the liver.
Anemia tends to accompany cancer due to the inflammation caused by the disease. This inflammation decreases red blood cell production. Anemia is also a side effect of chemotherapy, since the treatment slows down production of new blood cells by the bone marrow.
There’s another ailment that can be life-threatening if its symptoms are missed. And since it’s a leading cause of death for people with many different kinds of cancer, it’s one we need to know more about….
The danger of blood clots
I’m talking about venous thromboembolism (VTE), or blood clots.
These clots develop deep in the veins and are a leading cause of death in people with cancer, resulting in heart attack, stroke and pulmonary embolism.
The more advanced the cancer stage, the higher the risk for VTE. And certain types of cancer put you at elevated risk as well, including blood cancers like lymphoma and myeloma and cancers involving the pancreas, prostate, stomach, brain, kidneys, lungs, uterus and ovaries.
Research shows people with cancer are nine times more likely to get blood clots than people who don’t have cancer. And death from blood clots comes in second only to the direct effects of the cancer itself.
According tot the Fred Hutchinson Cancer center, the increased risk occurs because surgeries immobilize patients, chemotherapy inflames the blood vessels and veins, and the blood becomes clogged with bits of dead cancer cells.
“We don’t talk about blood clots enough in oncology, but we’re getting better,” says Dr. Michael B. Streiff, a professor at Johns Hopkins and chair of the National Comprehensive Cancer Network (NCCN) Guidelines® Panel for Cancer-Associated Venous Thromboembolic Disease. “Not only do tumors put people at risk for blood clots, but cancer treatments can also put people at risk.”
Blood clot symptoms can sometimes be vague or seem out of the blue. They include:
- Swelling, especially in the limbs
- Deep muscle aches in the legs or arms
- Shortness of breath
- Chest pain
- Back pain
People with cancer should talk to their doctor about these or any other changes in their body, Streiff says.
“Despite the known link between blood clots and cancer, there is still a lack of awareness about thrombosis risk in patients with cancer,” notes Aviva Schwartz, director, content and education, North American Thrombosis Forum. “It’s critical to address this knowledge gap and encourage open conversations between patients and healthcare providers.”
To help educate patients on preventing and treating these blood clots, NCCN has published a supportive care patient guideline. The NCCN Guidelines for Patients®: Blood Clots and Cancer can be downloaded for free at NCCN.org/patientguidelines, or via the NCCN Patient Guides for Cancer App. Printed versions are available for a small fee at Amazon.com.
According to Streiff, the book will educate patients and caregivers about what they can do to prevent blood clots, how to recognize the symptoms and what treatments are available if they experience VTE, pulmonary embolism or deep-vein thrombosis.
The guideline uses the latest evidence and expert consensus to recommend the best options for patient care. It puts NCCN’s medical recommendations into terms that are easy for patients to understand and includes images, charts and suggested questions to ask their physician.
Blood clot care is improving
Recent years have seen advances in risk assessment tools for VTE. These advances are helping doctors to understand which patients should proactively receive medications like anticoagulants, or blood thinners, and which should avoid them.
That’s important because cancer patients have issues unique to their treatments that others receiving anticoagulant therapy do not. For instance, many receive treatment through a catheter that may have to be removed if they experience abnormal bleeding. And if surgery is needed without enough time to go off of a blood thinner, they’d need a fast-acting antidote for the anticoagulation medicine.
The best defense against blood clots is not to get them in the first place. And one of the best ways to help prevent blood clots is to move your body regularly. Exercise is recommended for cancer patients who are up to it.
Other factors can help further reduce blood clot risk. People who exercise regularly and take the following additional steps are 38 to 44 percent less likely to develop a blood clot:
- Avoid smoking
- Follow a healthy diet
- Maintain a healthy body mass index (BMI)
- Control cholesterol and blood sugar levels
- Maintain healthy blood pressure
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Graft-Versus-Host Disease (GVHD) — Memorial Sloan Kettering Cancer Center
Anemia and Cancer — The University of Texas MD Anderson Cancer Center
Venous Thromboembolism (Blood Clots) and Cancer — Centers for Disease Control and Prevention