Cancer is one of the risk factors related to the origin of a deep venous thrombosis or a pulmonary embolism (two faces of venous thromboembolic disease, VTE). 1 out of 5 people with VTE have cancer. This fact has led many RIETE investigators to observe the evolution of these patients in order to discover VTE behavior guidelines when this is associated to a malignant tumor.
The results of this study, led by Isabelle Mahé, internist at Lariboisière Hospital of Paris (France), show that treatment with low molecular weight heparin is effective; however, just for six months. Despite many times the administration of anticoagulant drugs is extended in order to avoid a new VTE episode, it is still unclear that this is the best option in all kinds of cancer.
In fact, the study led by Dr. Mahé confirms that VTE behaves in a different way depending on the origin of the tumor. Therefore, in many cases the fact of extending the anticoagulant therapy translates into an unnecessary elevated risk of bleeding for the patient.
Among the 3.947 patients analyzed with VTE and cancer (breast, prostate, lung or colon), the highest risk of having a new thrombosis or a pulmonary embolism appeared during the three first months of treatment and with a different association depending on the type of cancer. In patients with breast cancer, chances of recurrence were minimal (1,9% of the cases) and similar to the risk of bleeding, while among the lung cancer patients, the risk was the most elevated one (6,6% of the cases) and three times higher than the risk of bleeding.
The study also shows that the risk of bleeding is high during the first three months of anticoagulant therapy, which reduces from that moment on, and mortality is also superior in the first three months of VTE, especially in the cases of lung cancer (39% of cases, compared to 11% of breast cancer).
The results of this study were recently revealed, at the congress of the International Society on Thrombosis and Haemostasis held in Toronto at the end of June. The following relevant information was also discussed at the Meeting:
- Venous thromboembolic disease is the third vascular mortality cause.
- It is a public health problem still unknown among population: A thrombus kills one person every six minutes
- Superficial vein thrombosis (phlebitis or thrombophlebitis) is a sign of a potential case of deep venous thrombosis
- Patients admitted at hospital due to cancer have more chances of developing a VTE.
- VTE incidence among cancer patients varies between 2% and 10% of the cases, depending on the type of tumor.
- Mortality of patients with cancer and VTE is higher than in patients with cancer and no VTE.
- There is a relationship between VTE and myocardial infarction.
- Posthrombotic syndrome affects between 20% and 50% of people who suffer from a deep venous thrombosis in the leg.
- Non-fatal recurrence of VTE affects 30% of the patients 10 years after their first diagnosis.
- 40% of the people who suffer from a VTE will have chronic pain, chronic inflammation or discomfort. Hence, more support services are needed.
- For every hour that a person is sitting down and without moving, there is an increase of 10% of developing a VTE.
- More than 70% of the VTE cases that appear at hospital can be preventable. Less than 50% of the patients receive the adequate preventable treatment.
- More than 60% of the VTE cases take place after hospitalization.
- VTE patients need more psychological support.
RIETE group has experts of 24 countries worldwide who work with a database of more than 58.000 VTE patients.