Venous thromboembolism and cancer

Abstract Venous thromboembolism occurs in up to 10% of patients with cancer. The incidence of thrombosis is varying with the nature, the histologic type and the stage of the disease. The risk of thrombosis is also increased by most of anticancer treatments and supportive care. Although long-term prophylactic treatment is able to decrease the rate of venous thromboembolism in patients with cancer, the absolute reduction is too low to give long-term prophylaxis, except for some rare exceptions. The treatment of cancer associated thrombosis is based on the use of low-molecular weight heparin for at least three to six months. In most cases, anticoagulation should be given for a longer period but the choice of the drug should be indi- vidualized on the basis of the evolution of the underlying cancer, overall prognosis, tolerance of injections and patient's preference. Recurrent venous thromboembolism during treatment with low-molecular weight heparin can be treated with a 10% dose escalation. Dose should be adjusted during periods of thrombocytopenia. Finally, the direct oral anticoagulants have not been compared with low-molecular weight heparins for the treatment of cancer associated thrombosis.