Table of ContentsView AllTable of ContentsOverviewRisk FactorsSymptomsPrevention
Table of ContentsView All
View All
Table of Contents
Overview
Risk Factors
Symptoms
Prevention
Blood clots related to chemotherapy are talked about less than, say, nausea and vomiting, but that doesn’t mean they are less of a problem. In fact, compared to the well-known symptoms of nausea, fatigue, and hair loss, they can be much more dangerous. That said, understanding the risk factors, knowing ways to lower your risk, and recognizing the symptoms can all help you reduce your risk during cancer treatment.
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Blood clots—otherwise known in medical lingo as “venous thrombosis,” are indeed a significant concern in people with cancer. We’ve known for some time that people with cancer in general, not just those receiving chemotherapy,have an increased risk of blood clots.
On their own, blood clots in the arms and legs can be painful, but the greatest concern is that these clots will break off and travel to the lungs. When this occurs, something referred to as apulmonary embolism, it is a medical emergency.
If you travel internationally, you may be familiar with the pre-flight videos which tout the importance of leg exercises toprevent blood clots, but we seldom hear of this risk with otherwise predisposing activities—such as going through chemotherapy.
In this case, what you haven’t heard may hurt you. In fact, this is one aspect through whichbeing your own advocate in your cancer care, learning about this potential complication, and contacting your healthcare provider if you are concerned—can really make a difference in your well-being and possibly even your outcome.
It’s always been suspected that people going through chemotherapy have an increased risk of blood clots, but it wasn’t until 2013 that this aspect of cancer treatment was evaluated alone. In a large study, it was found that the incidence of blood clots going to chemotherapy was 12.6%, compared to a risk of 1.4% for cancer patients not receiving chemotherapy.
The risk was higher in some cancers than others, with cancers such as pancreatic cancer and lung cancer having greater risk. In addition, some chemotherapy drugs and medications used to counteract the side effects of chemotherapy were also associated with an increased risk. In this study, drugs which increased risk included Platinol (cisplatin), Avastin (bevacizumab), and Epogen or Procrit (the red blood stimulator erythropoietin.)
2:22Common Causes & Risk Factors for Blood Clots
2:22
Common Causes & Risk Factors for Blood Clots
In addition to chemotherapy, what other treatments and conditions may raise the risk of blood clots for people living with cancer? Some risk factors include:
In order to be aware of possible symptoms, it can help to break these down into symptoms usually seen with a blood clot in the legs (venous thrombosis) and symptoms related to a blood clot that has broken off and traveled to the lungs (pulmonary embolism.)
Symptoms of venous thrombosis (blood clots in the leg) include symptoms in the calves or upper leg including:
Symptoms due to pulmonary embolism may include:
Medication:Medications such as anticoagulants are being used more frequently in recent years to reduce the risk of blood clots in cancer patients. This is referred to as a “prophylactic anticoagulation” which, translated, means preventative formation of a clot.
There are several medications healthcare providers may recommend prophylactically. Recent studies suggest that medications such as heparin work better in people with cancer than medications that interfere with vitamin K—such as warfarin, but different medications may be recommended depending on your particular situation.Some of these drugs (which you may hear referred to as low molecular weight heparin) include:
Self-Care:In medicine, we tend to talk about drugs when it comes to prevention, yet there are many things you can do yourself to reduce your risk. The first and most important step is simply to educate yourself and ask questions. Become familiar with the symptoms of blood clots and pulmonary embolism. If you are concerned at all, don’t wait, but contact your healthcare provider immediately. Ask your oncologist if there is anything special you can do to reduce your risk, or if she would recommend a medication to lower risk. In addition, you may wish to:
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6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Society of Clinical Oncology.Blood clots.Khorana A, Dalal M, Lin J, Connolly G.Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States.Cancer. 2013;119(3):648-55. doi:10.1002/cncr.27772National Heart, Lung, and Blood Institute.What is venous thromboembolism?Garcia Escobar I, Antonio Rebollo M, Garcia Adrian S, et al.Safety and efficacy of primary thromboprophylaxis in cancer patients.Clinical and Translational Oncology. 2017;19(1):1-11. doi:10.1007/s12094-016-1500-6Centers for Disease Control and Prevention.About venous thromboembolism (blood clots).Texas Heart Institute.Venous blood clots (including DVT).Additional ReadingPosch F, Konigsbrugge O, Zielinski C, Pabinger I, Ay C.Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants.Thrombosis Research. 2015;136(3):582-9. doi:10.1016/j.thromres.2015.07.011Vitale C, D’Amato M, Calabrò P, Stanziola AA, Mormile M, Molino A.Venous thromboembolism and lung cancer: A review.Multidisciplinary Respiratory Medicine. 10(1):28. doi:10.1186/s40248-015-0021-4
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Society of Clinical Oncology.Blood clots.Khorana A, Dalal M, Lin J, Connolly G.Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States.Cancer. 2013;119(3):648-55. doi:10.1002/cncr.27772National Heart, Lung, and Blood Institute.What is venous thromboembolism?Garcia Escobar I, Antonio Rebollo M, Garcia Adrian S, et al.Safety and efficacy of primary thromboprophylaxis in cancer patients.Clinical and Translational Oncology. 2017;19(1):1-11. doi:10.1007/s12094-016-1500-6Centers for Disease Control and Prevention.About venous thromboembolism (blood clots).Texas Heart Institute.Venous blood clots (including DVT).Additional ReadingPosch F, Konigsbrugge O, Zielinski C, Pabinger I, Ay C.Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants.Thrombosis Research. 2015;136(3):582-9. doi:10.1016/j.thromres.2015.07.011Vitale C, D’Amato M, Calabrò P, Stanziola AA, Mormile M, Molino A.Venous thromboembolism and lung cancer: A review.Multidisciplinary Respiratory Medicine. 10(1):28. doi:10.1186/s40248-015-0021-4
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Society of Clinical Oncology.Blood clots.Khorana A, Dalal M, Lin J, Connolly G.Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States.Cancer. 2013;119(3):648-55. doi:10.1002/cncr.27772National Heart, Lung, and Blood Institute.What is venous thromboembolism?Garcia Escobar I, Antonio Rebollo M, Garcia Adrian S, et al.Safety and efficacy of primary thromboprophylaxis in cancer patients.Clinical and Translational Oncology. 2017;19(1):1-11. doi:10.1007/s12094-016-1500-6Centers for Disease Control and Prevention.About venous thromboembolism (blood clots).Texas Heart Institute.Venous blood clots (including DVT).
American Society of Clinical Oncology.Blood clots.
Khorana A, Dalal M, Lin J, Connolly G.Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States.Cancer. 2013;119(3):648-55. doi:10.1002/cncr.27772
National Heart, Lung, and Blood Institute.What is venous thromboembolism?
Garcia Escobar I, Antonio Rebollo M, Garcia Adrian S, et al.Safety and efficacy of primary thromboprophylaxis in cancer patients.Clinical and Translational Oncology. 2017;19(1):1-11. doi:10.1007/s12094-016-1500-6
Centers for Disease Control and Prevention.About venous thromboembolism (blood clots).
Texas Heart Institute.Venous blood clots (including DVT).
Posch F, Konigsbrugge O, Zielinski C, Pabinger I, Ay C.Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants.Thrombosis Research. 2015;136(3):582-9. doi:10.1016/j.thromres.2015.07.011Vitale C, D’Amato M, Calabrò P, Stanziola AA, Mormile M, Molino A.Venous thromboembolism and lung cancer: A review.Multidisciplinary Respiratory Medicine. 10(1):28. doi:10.1186/s40248-015-0021-4
Posch F, Konigsbrugge O, Zielinski C, Pabinger I, Ay C.Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants.Thrombosis Research. 2015;136(3):582-9. doi:10.1016/j.thromres.2015.07.011
Vitale C, D’Amato M, Calabrò P, Stanziola AA, Mormile M, Molino A.Venous thromboembolism and lung cancer: A review.Multidisciplinary Respiratory Medicine. 10(1):28. doi:10.1186/s40248-015-0021-4
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