DVT risk factors

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Cancer can lead to DVT. What else might add to your risk?  

Active Therapy for Cancer

Cancer therapy itself has been shown to increase the risk for VTE, including chemotherapy, anti-angiogenic therapy, hormonal therapy, and erythropoietin-stimulating agents1. The underlying mechanisms are poorly understood, but it has been suggested that many of these therapeutic agents induce vascular damage2.

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Surgery 

Thrombosis is also a common complication of cancer-related surgery. The frequency of VTE in patients undergoing cancer surgery is roughly twice that seen in patients without malignancies who have similar operations3.

Hospitalisation

Hospitalisation is often associated with prolonged immobility (due to bedrest or recovery). This is a strong risk factor for cancer-associated thrombosis. In the hospitalised setting, the rate of VTE in cancer patients is twice that of non-cancer patients4.

Central Venous Catheters

Central venous catheters (CVC), commonly inserted for chemotherapy, are also associated with a risk of VTE. The incidence of CVC-related deep vein thrombosis (DVT) assessed by venography has been reported to vary from 30% to 60% but catheter-related DVT in adult patients is symptomatic in only 5% of cases5.

The wide variability in the incidence of catheter-related thrombosis may be due to differences in catheter type, position, duration of insertion, type of malignancy, and use of different chemotherapeutic agent6.

Obesity

Obesity is also an important risk factor for DVT/PE in both men and women. Studies have shown that obese individuals have nearly twice the risk of both PE and DVT7.

Hormone Replacement Therapy (HRT) and contraceptives

Many women use HRT treatments to alleviate the symptoms of menopause or osteoporosis. These medicines often contain a synthetic version of the hormone called oestrogen, which causes blood to clot more easily. Similarly, birth control methods like the combined contraceptive pill and contraceptive skin patch also contain oestrogen8

If you are already at risk for developing DVT or undergoing treatment, be sure your doctor is aware of any HRT or contraceptive medication you are taking, so you can discuss what is right for you.

Pregnancy

Pregnancy can also increase the chances of developing DVT. Pregnant woman can keep their risk at a minimum by watching out for and reducing other risk factors wherever possible. In particular, if you are on bed rest or generally moving slowly, talk with your doctor about types of exercises that can keep your blood flowing.

Other additional risk factors

There are other risk factors, but they are rare and less relevant for cancer patients. For example, some genetic diseases can trigger DVT and these are usually only identified when a patient does not fit the usual profile (recent surgery or cancer). These diseases include rare Protein C, Protein S and Antithrombin III deficiencies.

Interested to know more? Watch our video which explains why the body makes blood clots



If you need more information about any of the above risk factors or conditions, please contact your doctor.

References

  1. Hogg K, Carrier M “Prevention and treatment of venous thromboembolism in patients with cancer” Ther Adv Hematol 2011; 3 (1), p. 45-58.
  2. Blann A, Dunmore S. “Arterial and Venous Thrombosis in Cancer Patients”. Card Res Practice 2011; Article ID 394740.
  3. Rao B.B., Kalayarasan R, Kate V, Ananthakrishnan “Venous Thromboembolism in Cancer Patients Undergoing Major Abdominal Surgery: Prevention and Management. ISRN Vasc Med 2012*; Article ID 783214.
  4. Piatek C., O`Connell C.L, Liebman H.A “Treating venous thromboembolism in patients with cancer” Expert Rev Hematol 2012, 5(2), p. 201-209.
  5. Debordeau P., Chahmi D.K, Zammit C., Farge-Bancel D. “ Venous thromboembolism associated with long-term use of central venous catheters in cancer patients”. Pat Biol 2008; 56 p. 211-219.
  6. Lee A.Y.Y., Levine M.N., Butler G., Webb C., Constantini L., Gu C., Julian J.A. “Incidence, risk factors and outcomes of catheter-related thrombosis in adult patients with cancer” J Clin Oncol 2006; 24:p 1404-1408.
  7. Stein P.D., Beemath A., Olson R.E “Obesity as a risk factor in venous thromboembolism” Am J Med 2005; 118, p. 978-980.
  8. Moheimani F., Jackson D.E “Venous thromboembolism: classification, risk factors, diagnosis and management. ISRN Hematol 2011, Article ID 124610.

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