Thromboembolic Disorders in Cancer

Abstract

Complex factors, including substances in cancer cells, cancer treatment effects, and venous stasis associated with chronic illness, blood vessel wall injury, and immobility, interact to place patients with cancer at risk for thrombosis. This article describes the etiology, clinical manifestations, diagnostic tests, and treatments for venous and pulmonary emboli associated with cancer. It explores the nurse's role in assessing patients who are at risk, managing symptomatic thrombosis and primary and secondary prevention of emboli, and administering anticoagulant therapy. As growing numbers of patients are treated in outpatient settings, oncology nurses play a critical role in the coordination of care for patients at risk for thrombosis. A nursing care plan summarizes key nursing strategies for assessment and intervention.

Predictors of In‐Hospital and Long‐Term Clinical Outcome in Elderly Patients with Massive Pulmonary Embolism Receiving Thrombolytic Therapy

“…[1][2][3]5,14 Moreover, the prevalence of acquired and specific clinical conditions predisposing to thromboembolism, as well as PE-related morbidity and mortality, significantly increase with aging. [1][2][3]5,[14][15][16][17][18][19][20][21] The study results indicate that higher serum levels of cTn-IFa specific marker of cardiac damageFon admission to the emergency department and the occurrence of thrombocytopenia after UFH-and r-TPA-associated therapy are significantly associated with greater risk of in-hospital mortality in elderly patients with central and massive PE requiring thrombolysis. Moreover, historical findings of cancer and CVD were significantly associated with greater risk of unfavorable evolution in the same setting in the long term.…”

Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation

“…There are alterations in coagulation and anticoagulant proteins and endothelial cells due to the cytotoxic agents. In addition, the tumor itself can produce procoagulants and activate endogenous prothrombotic factors [5,6].…”

“…The 1-year survival rate of cancer patients afflicted by such an event is 12%, versus 36% in patients without embolism [4]. Pathogenetic mechanisms of hypercoagulability are the production of procoagulants and the activation of endogenous prothrombotic factors by the tumor itself [5,6].…”

Thromboembolic Events Associated With Novel Therapies in Patients With Multiple Myeloma: Consensus Statement of the IMF Nurse Leadership Board

“…Certain populations are at increased risk for thromboembolic events, including DVT and PE. Patients with cancer are among those with an increased risk for thromboembolic events (Heit et al, 2000(Heit et al, , 2002Otten et al, 2004;Prandoni, 2005;Van Gerpen & Mast, 2004), and patients with multiple myeloma may incur an even higher incidence (Hussein, 2006;Palumbo et al, 2008). Some combination treatments and concomitant therapies for multiple myeloma also may increase the incidence of thromboembolic events (Palumbo et al).…”