Chemotherapy and Deep Vein Thrombosis

In a newsletter last month I did not mention one of the conditions which can lead to Deep Vein Thrombosis (DVT)…I probably missed more than one. A wonderful customer reminded me and I thought it was important enough that we should revisit this.

Our customer wrote: In one of your recent blogs, you listed conditions that cause blood clots, but one cause was not on the list: chemotherapy.
During chemo, I developed classic signs of marked bilateral calf pain. The symptoms appeared neither suddenly nor gradually (I know, big help!). Thank goodness I didn’t let the pain go unaddressed, and when after my oncologist examined me, he asked if I wanted an ultrasound, I agreed. However I don’t think he believed anything was wrong.
During the ultrasound of my legs, even before I stepped down from the procedure table, not only had the techs told me I had blood clots, but they insisted I be wheel-chaired back to my doctor’s office in the same complex. I received immediate anticoagulation therapy.
By reporting this pain to my doctor, I saved my own life. Both the Coumadin and the compression stockings successfully cleared the clots; a repeat ultrasound last week showed no new clots, and the technician said “Your veins look beautiful!”
Who would have thought I would rejoice over my “beautiful veins”?
Thank you for fine service over the years. I encourage all women who are on their feet a lot to wear compression stockings, as I like to say they “hold up the world.” My leg pain–even clot free–is severe, and the stockings totally eliminate that pain.”

There are several reasons blood clots form in cancer patients who are on chemotherapy. I will try to address a few of them here.

Patients with cancer may have a higher number of platelets and clotting factors in their blood, possibly because cancer cells produce and release chemicals that stimulate the body to make more platelets. Platelets are very small, special blood cells that are involved in clot formation. They cluster together to form a plug to stop bleeding. They also produce other chemicals to help the blood clot and repair the leaking blood vessel.

Clotting factors are proteins made naturally by the body. They combine with platelets to help form blood clots and prevent bleeding. If you have more platelets and higher amounts of clotting factors than normal in your body, your blood is more likely to clot.

When chemotherapy kills cancer cells, the cells can release substances that cause an increase in blood clotting (coagulation). Specific types of chemotherapy drugs are more likely to cause a blood clot than others. A cancer patient’s doctor should explain to them if the drugs they are having increase their risk of getting a blood clot. Doctors are very clear that the benefits of the chemotherapy far outweigh the risks for developing a blood clot and patients should keep taking it. But patients should know the symptoms of a blood clot just in case.

Surgery and chemotherapy can both damage the walls of blood vessels. This will increase your risk of developing a blood clot.

The blood normally has proteins that are anticoagulants in it that help to thin the blood. If you have cancer you may have lower levels of these proteins.

Sometimes cancer or treatment can make a patient feel very ill and too tired and weak to move around as usual. Being inactive increases the risk of clotting because the normal movement of the leg muscles helps to pump the blood back up to the heart.

Just in case, cancer patients should be aware of the common symptoms of a blood clot:

  • Pain, redness and swelling around the area where the clot is
  • The area around the clot may feel warm to touchIf these occur, the cancer patient should not wait to see if it goes away. The symptoms should be reported to the physician or the physician’s nurse immediately.To help prevent clots:
  • Talk to your physician. (I have many oncologist around the country who want their cancer patients in some kind of compression.)
  • Take short walks as often as possible
  • If you can’t move around much, do simple leg exercises every hour, such as bending and straightening your toes and making figure 8’s.
  • Drink plenty of water to stay hydrated

With the advancement in medicine, cancer is being diagnosed earlier, and there are many cancer survivors. As some of you know my husband, Rod, is a cancer survivor. He wears his support socks every day and is doing quite well. We don’t want other cancer survivors to have to deal with DVT or worse. Advise you friend, family member, or loved one to talk to their oncologist about wearing support socks.


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