Diagnosis, Treatment, and Prevention of Cancer-Associated Thrombosis

Abstract The management of patients with cancer has evolved significantly in the past two decades. New approaches to therapy using specific targeting of functional activities such as tyrosine kinases, in addition to immune modulation, antiangiogenesis agents, and other approaches in conjunction with conventional chemotherapy and radiation therapy, have significantly improved outcomes. Patients with cancer are living for longer periods of time. Many malignancies can be thought of as chronic diseases, with patients living for many years and therefore experiencing complications related to cancer and its treatment for longer periods of time. Venous thromboembolism (VTE) is a complication of both the cancer itself and the associated care, with some treatments significantly increasing the risk of development of VTE. This chapter is a comprehensive review of cancer and VTE. The specific risks associated with cancer and the development of VTE, are reviewed. Data supporting the use of VTE prophylaxis are discussed, along with the acute and chronic management of VTE. Special situations regarding VTE management that are unique to the patient with cancer-associated VTE are covered. Reversal strategies for patients on anticoagulants who develop bleeding are also reviewed.