Please share this webinar with anyone who may be interested! Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR In this webinar: ● Signs and symptoms of blood clots, also known as venous thrombosis ● What types of treatments are available ● Why people living with cancer should be aware of the dangers of blood clots and what to do if they occur. View the video: https://youtu.be/PbZQCHRhoOQ Follow our social media accounts: Twitter - https://twitter.com/survivornetca Facebook - https://www.facebook.com/CanadianSurvivorNet Pinterest - https://www.pinterest.com/survivornetwork YouTube - https://www.youtube.com/user/Survivornetca

1. Q&A with an Expert about
Blood Clots and Cancer
World Thrombosis Day
Marc Carrier

2. • October 13: Birthday of Rudolf Virchow, a pioneer
scientist in determining why patients develop blood
clots and advanced our understanding of this
condition
• Increase global awareness of thrombosis and
reduce death and disability caused by the disease
• More than 600 organizations in 80 Countries are
participating

3. Blood Clots in the Legs
• Deep vein thrombosis
(DVT) - A blood clot
that forms in a deep
vein (usually in the
leg).
Tapson VF. N Engl J Med 2008; 358(10):1037-52.

4. Blood Clots in the Lungs
• Pulmonary embolism
(PE) - A blood clot in
the lungs. PE occurs
when a DVT breaks
free from a vein wall,
travels to the lungs
and blocks some or all
of the blood supply to
the lungs.
• DVT + PE = VTE
Tapson VF. N Engl J Med 2008; 358(10):1037-52.

5. Are Blood Clots Important?
• VTE is a leading cause of death
and disability worldwide.
– 10 million cases of VTE occur
annually
• 45,000 patients in Canada
• VTE-related events kill more
people than AIDS, breast cancer,
prostate cancer and motor
vehicle crashes combined

6. Are Blood Clots Frequent Among
Cancer Patients?
• Cancer alone is
associated with a 4
fold risk of blood clots
• Cancer and
chemotherapy: 7 fold
increased risk

7. Blood Clots are an Important
Cause of Death in Cancer Patients
• Blood clot is the second
leading cause of death
in cancer patients
• Annual death rate for
VTE is increased by 47-
fold increase compared
to the general
population
Khorana AA et al. J Thromb Haemost 2007;5:632-4.
Figure from Khorana AA et al. Thromb Res 2010;e-pub.

8. Blood Clots are Associated with
Decrease Quality of Life in Cancer
Patients
• DVT:
1/3 patients will have long term complications such
as chronic lower leg swelling, dull achy pain, leg
heaviness and skin changes
• PE:
–Small percentage will have chronic shortness of
breath and unable to walk long distances
8

9. Risk Factors
• Growing cancer or spread to to multiple sites
• Central venous catheters
– PICC lines, or Port-a-cath
• Surgery
• Chemotherapy

10. Other Risk Factors
• Obesity
• Smoking
• Alcohol consumption
• Not moving for long periods of time (e.g.
bedrest)

11. Hospitalization is an Important Risk
Factor

12. Warning Signs and Symptoms
• DVT:
– Pain or tenderness, often starting in the calf
• “Charlie horse”
– Swelling, including the ankle or foot
– Redness or noticeable discoloration
– Warmth
Tell your health
care provider!!!

13. Warning Signs and Symptoms
• PE:
– Unexplained shortness of breath
• Especially while exercising, walking up stairs
• Other day to day chores
– Rapid breathing
– Chest pain (may be worse upon deep breath)
• Often feels like a sharp stab from a knife.
– Rapid heart rate
– Light-headed and dizzy
Go to the ER
or call 911

14. Prevention
• Talk about the risk of blood clots with
healthcare professionals
– Especially:
1.During hospitalization
2.Surgery
3.Other high risk periods (e.g. PICC line insertion)

15. Prevention
• Avoid known and modifiable risk factors
• Anti-clotting medications
– e.g., blood thinners, referred to as
"anticoagulants")
• Mechanical devices
– e.g., compression stockings, intermittent
pneumatic compression devices
• Hospital patients may also be instructed to
move around or do foot/leg exercises as soon
and as often as possible.

16. What are the Treatment for Blood
Clots?
• Injectable blood thinner called Low Molecular
Weight Heparin (LMWH)
– Drug given by a needle under the skin
• Effective and no interactions with anti-cancer
treatment
– Comes in pre-loaded prefilled syringes
i.e. Easy to use
– Usually the injection is given once a day

17. What are the Treatment for Blood
Clots?
• Dosing:
– Depends on your weight and how well your
kidneys are working
• Treatment will continue for at least 3 to 6
months
– Then your doctor will decide if you can stop or
need to continue blood thinner

19. Can I Have a Treatment with Pills?
• Warfarin (Coumadin)
– Old “standard”
– Can be high maintenance and
difficult to control in cancer patients
• Blood work….

20. Can I have One of the Newer
Blood Thinner?

21. Take Home Messages
• Blood clots are common in patients with
cancer
• Prevention is important
• Recognition of symptoms is key to:
1. Early diagnosis
2. Initiation of effective blood thinners – save lives
3. Avoid long-term complications

22. Patient resources
•Clot Matters
• http://www.clotsmatter.ca/
•Thrombosis Canada
• http://thrombosiscanada.ca/
•World Thrombosis Day
• http://www.worldthrombosisday.org/