Designed and created by Guideline Central in participation with the International Initiative on Thrombosis and Cancer
Treatment and Prophylaxis of Venous Thromboembolism in Patients with Cancer Including Patients with COVID-19
Publication Date: July 1, 2022
Last Updated: March 3, 2023
This patient summary means to discuss key recommendations from the International Initiative on Treatment and Prophylaxis of Venous Thromboembolism in Patients with Cancer Including Patients with COVID-19.
- Cancer increases the risk of unwanted blood clotting. Clots can hinder blood circulation and can cause pulmonary elbolism (migrate to the lungs).
- Some of the most common causes of venous thromboembolism are chemotherapy drugs and the intravenous lines (catheters) used to deliver them.
- Symptoms of blood clots include leg or arm swelling, pain, and color change to red or purple.
- Symptoms of pulmonary embolism include shortness of breath, chest pain, cough, and heart pounding.
- This patient summary focuses on the prevention and treatment of thromboembolism in cancer patients.
Treatment and Prevention
Treatment and Prevention
- The goal of both prevention and treatment is to “thin” your blood so it clots normally.
- The preferred anticoagulant (blood thinner) is low-molecular-weight heparin (LMWH)
- LMWH is given as an injection either into the skin (like insulin) or directly into a vein.
- For frequent doses of LMWH, a catheter is often left in place for the duration of your treatment.
- Larger veins are preferred over smaller ones.
- Catheters can be placed in arm or neck veins and threaded into larger veins or inserted surgically directly into large veins.
- Many patients already have central catheters to receive chemotherapy.
- Several other anticoagulants, some of which are taken by mouth, are available, depending on your particular situation.
- unfractionated heparin
- vitamin K antagonists (coumadin)
- Thrombolysis is dissolving blood clots using intravenous medications. (Thrombolysis is also used to treat strokes and heart attacks.)
- Thrombectomy uses long, thin devices to remove clots from blood vessels.
- Inferior vena cava filters are expandable sieve-like devices threaded into the large vein below the heart to catch clots before they reach the lungs.
- For prevention, walking, moving your legs regularly, and alternating pressure devices all improve blood flow from your legs, which greatly reduces the risk of clotting.
- This guideline also covers the management of thromboembolism in the presence of brain tumors, kidney failure, other bleeding disorders, pregnancy, obesity and COVID-19.
- LMWH: Low Molecular Weight Heparin
Farge D, Frere C, Connors JM, Khorana AA, Kakkar A, Ay C, Muñoz A, Brenner B, Prata PH, Brilhante D, Antic D, Casais P, Guillermo Esposito MC, Ikezoe T, Abutalib SA, Meillon-García LA, Bounameaux H, Pabinger I, Douketis J; International Initiative on Thrombosis and Cancer (ITAC) advisory panel. 2022 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer, including patients with COVID-19. Lancet Oncol. 2022 Jul;23(7):e334-e347. doi: 10.1016/S1470-2045(22)00160-7. PMID: 35772465; PMCID: PMC9236567.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.