The head of the Thrombosis Unit of MD Anderson Madrid - Hospiten, Raquel de Oña, has alerted that people with cancer present a risk of venous thromboembolism that can be up to 12 times higher than that of the population without this disease and can be up to 23 times greater when they are undergoing active oncological treatment.
As the specialist details, cancer-associated thrombosis (CAT, for its acronym in English, Cancer-Associated Thrombosis) constitutes a frequent and potentially serious complication in cancer patients, as it encompasses arterial and venous thrombotic events that can occur at any stage of tumor evolution.
"Cancer-associated thrombosis should no longer be an unknown complication. Our goal is for each patient to know their individual risk and the available measures to reduce it," the doctor indicated.
De Oña emphasizes that the risk of developing thrombosis does not obey a single trigger, but is multifactorial, heterogeneous, and changing, which can be modified throughout the oncological process. This risk involves patient-specific factors, such as hypertension, diabetes, or dyslipidemia; tobacco or alcohol consumption; personal history of thrombosis, as well as prolonged immobilization or sedentary lifestyle.
The characteristics of the tumor are also determining, including its location —with special vulnerability in certain cancers, such as those of the pancreas or lung—, the presence of advanced stage disease, or the first months after diagnosis. To these elements are added factors linked to treatment, such as certain chemotherapy regimens, immunotherapy, hormone therapy, central venous catheters, or surgical interventions.
Prevention and early detection to reduce complications
The head of the Thrombosis Unit of MD Anderson Madrid - Hospiten explains that the occurrence of thrombosis notably complicates the management of the cancer patient, as it may necessitate hospitalization, force the postponement of already planned treatments, and complicate decisions regarding anticoagulation due to the increased risk of bleeding.
This clinical impact is added to the psychological burden: "The diagnosis can generate fear and become a traumatic experience. Thrombosis is a frequent and serious complication, associated with an increase in morbidity and mortality," says the specialist.
Thrombotic episodes can debut with evident clinical symptoms or be detected casually during cancer control tests. As thrombosis hinders or interrupts normal blood flow within a vessel, the symptoms depend on whether it affects an artery or a vein, as well as the location, extent, and severity of the obstruction.
"In deep vein thrombosis, swelling, pain, or increased volume of a leg or an arm may appear. In a pulmonary embolism, sudden onset respiratory difficulty, chest pain, tachycardia, dizziness, fever, or loss of consciousness may occur. When there is cerebral thrombotic involvement, sudden neurological symptoms may appear, such as difficulty speaking, loss of strength or sensation on one side of the body, and vision disturbances. Recognizing these warning signs allows for early medical attention," De Oña has indicated.
Identifying patients with higher thrombotic risk
Among the priorities of the Thrombosis Unit at MD Anderson Madrid - Hospiten is the identification of patients undergoing active oncological treatment with a high risk of thrombosis, assessing simultaneously their bleeding probability. This assessment, they emphasize, is individualized and is reviewed periodically throughout the course of treatment. Some selected profiles may benefit from primary thromboprophylaxis with anticoagulant drugs during periods of maximum risk, although prevention does not imply indiscriminately anticoagulating all patients.
Another fundamental axis of the Unit is the educational work: in the consultation, it is explained what cancer-associated thrombosis is, the reasons why the risk increases, what warning signs should be monitored, when to seek a healthcare professional, and how to safely manage anticoagulant treatments.
Likewise, the team integrates the patient's close environment into this process. Family members and caregivers collaborate in detecting changes that the person with cancer might attribute to treatment fatigue, they promote adherence to medical recommendations and help to react to any warning signs.
"In the thrombosis consultation, we offer education and promote the empowerment of the patient and their trusted environment, so that they recognize the warning signs and actively participate in their safety," concludes the doctor.