Venous Thromboembolism (Blood Clots) in Patients with Cancer: Risk

B0002113 Electron micrograph of blood clot
Electron micrograph of blood clot (Photo credit: wellcome images)

The close association between cancer and thrombosis (blood clots) has been recognized for over 150 years. Today, I present a risk score for patients with cancer, based on several factors:

Very high risk: Stomach or pancreas cancer: 2

High risk (lung, lymphoma, gynecologic, bladder, testicular): 1

Pre-chemotherapy platelet count at least 350,000: 1

Hemoglobin level less than 10 or use of red blood cell growth factors: 1

Pre-chemotherapy leukocyte count over 11,000: 1

Body Mass Index 35 or higher: 1

High risk score: 3 or higher; intermediate risk = 1-2; low-risk = 0

When this risk model was retrospectively evaluated in large randomized trials, the risk of venous clots among high-risk patients was significantly reduced in those randomized to blood thinning drugs (thromboprophylaxis).

Other risk factors include infection, as well as lung or kidney disease.

The American Society of Clinical Oncology (ASCO) updated guidelines recommend that patients with cancer be educated about the symptoms and signs of blood clots, and that risk be assessed at the time of chemotherapy initiation and periodically thereafter. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

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Reference: The ASCO Post (volume 4, issue 11; 10 July 2013).

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Harvard AB Yale MD UPenn Radiation Oncology Radiation Oncologist, Seattle area

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