Management of cancer-associated venous thrombosis

Ozlem Er¹, Leo Zacharski²

¹Department of Medical Oncology, Erciyes University Medical Faculty, Kayseri, Turkey; ²Department of Medicine, Dartmouth Medical School, Lebanon, New Hampshire, USA

Abstract: The association between malignancy and venous thromboembolic disease has been recognized for over a century and a half. During this time, a substantial body of literature has developed showing that malignancy is not only a hypercoagulable state characterized by an increased risk of thrombosis but also that components of blood coagulation reactions are capable of supporting tumor growth and dissemination. In recent years a succession of meticulously performed clinical trials has clarified optimal therapy intended to both prevent and treat thromboembolism that occurs in the setting of cancer. However, much remains to be accomplished in terms of practitioner education on the merits of optimal therapy. Of perhaps greater interest is the possibility that drugs capable of controlling cancer-associated hypercoagulability may provide a means for improving cancer survival while avoiding the toxicities characteristic of conventional anti-tumor therapy. Clearly, ample incentive exists for collaboration between basic and clinical scientists interested in improving the management of malignancy and its thromboembolic complications.

Keywords: cancer, dalteparin, low molecular weight heparin, venous thrombosis