How To Save Cancer Patients Dying From Blood Clots

If you are a cancer patient you certainly don’t expect to die from a blood clot. You usually expect to die from the cancer itself. Cancer patients have a seven times higher risk of complications from blood clot formation. (1) One of those complications is death. Cancer patients have a dramatically increased risk of strokes, heart attacks and dangerous blood clots in the lungs (pulmonary embolism) and in the legs (deep vein thrombosis). (1) (6) That means some cancer patients die when the normal flow of blood is obstructed by a sticky clot.

Why Do Some Cancer Patients Form Life-Threatening Blood Clots?

Normal blood is mostly thin and watery and filled with cells that flow about easily without getting stuck together. Blood that is prone to clotting becomes thick and sticky… more like honey than water. This happens as a result of many chemical reactions between cells and tissues due to the presence of cancer itself or as a side effect or complication of cancer treatments. (1) (6)

?Cancer Physiology and Tumor Cells Promote Increased Blood Clotting

Tumor cells produce clotting substances  (1) (4)  The physiology of cancer itself is a state in which the blood is more prone to clot formation. That is, increased blood clotting is but one of the many changes that occurs in many cancers. This is often referred to as a state of hypercoagulation (increased clotting) or prothrombotic (promoting clot formation).

Tumor cells interact with our blood cells and the lining of our blood vessels (1) This can lead to reactions that make the blood sticky and stimulate clot formation (via specialized blood cells that are also a normal part of our immune system, e.g., monocytes, neutrophils, platelets).

Tumor cells cause increased inflammation (1) This makes the blood more “sticky” and prone to clot (due to the secretion of inflammatory molecules such as cytokines.

Stagnant blood circulation (hemodynamic compromise) (1) In many patients the blood does not circulate normally. When blood flow is slowed down due to the presence of a tumor, the blood tends to clot more. Think about a dam in a stream. When something is in the way, things get stuck.

Side Effects of Anti-Cancer Treatments and Therapies Can Increase Blood Clotting (1)

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Hormone therapy

What Should You Do?

Get up and move. Don’t be a couch potato. Exercise decreases risk of blood clot formation simply by keeping the blood flowing. Consult with your doctor to determine the safest exercise routine for you.

Drink plenty of healthy fluids every day. The blood is mostly water. When you are dehydrated, your blood becomes more thick and less watery.

If you form a blood clot for any reason, ask your doctor to screen you for cancer.

If you are a cancer patient and are undergoing cancer treatment, ask your doctor to monitor your blood for evidence of increased clotting. There are many “clotting factors” that can easily be measured in the blood. A few include D-Dimer, Fibrinogen, Factor V, Factor X, platelet count, prothrombin time and many more. (8)

Ask your doctor to measure your blood for factors associated with increased inflammation that effect clotting. (WBC, CRP, IL-1,IL-6, TNFa, NFKb for example)

Ask your doctor if any of the medications you are taking or treatments you are receiving can increase inflammation or increase the risk of blood clots.

If you are at increased risk for forming blood clots, ask your doctor to recommend a plan for prevention, an anti-clotting, anti-coagulation strategy. Today many doctors routinely recommend that patients take a baby aspirin on a daily basis as a form of prevention to reduce the risk of blood clot formation. Cancer patients who form clots are often prescribed much stronger medications. Some anti-clotting drugs have been shown to slow down the growth and spread of tumors in some breast, pancreatic, ovarian, colon and skin cancers. (5)

Be aware of drugs and treatments that reduce clotting and increase bleeding. It is also true that many treatments and medications have the opposite effect. Some common over the counter drugs such as Advil and Alleve as well as aspirin can reduce blood clotting leading to the side effect of excessive bruising or bleeding. If you notice you are bruising easily, your gums bleed every time you brush your teeth or you get a bloody nose frequently, these may be signs you are not clotting normally. See your doctor.

Be aware of how nutritional and herbal supplements can effect blood clotting.
Examples of widely used natural substances that impair normal clotting function include
omega-3 fish oils (EPA, DHA) (2) (4) (7), vitamin C, bromelain, tumeric, garlic, ginseng, ginger and red clover to name a few. (3) (4) (7) These supplements should be discontinued before surgeries to reduce the risk of excessive bleeding. These same substances are also valued as supportive therapies when there is increased risk of clotting, which is true for all cancer patients.

To Clot or Not to Clot Is a Delicate Balance

Any substance, whether a prescription drug or a natural substance, might increase or decrease normal blood clotting. A fine balance is necessary. This delicate balance lies in the territory where we are not at risk for either increased or decreased blood clotting. What we want is a state of normal blood clotting. This means that if you get a cut or have surgery, the blood will clot quickly and the bleeding will stop. On the other side, your blood should not be thick and sticky, but flow smoothly and normally throughout your body in a state that is not prone to abnormal clot formation which obstructs normal circulation. This can be life threatening.

As each person is unique, it essential that you consult with your health care provider to arrive at a plan that is safe and tailored to your risks and needs.

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These statements have not been evaluated by the FDA and not intended to diagnose, treat, cure or prevent any disease.

(1) Caine, Graham J., Stone, Paul S., The Hypercoagulable State of Malignancy: Pathogenesis and Current Debate. Neoplasia November 2002 4(6):465-73
(2) Phang, M, Lazarus, S, Wood, LG, Garg, M. Diet and thrombosis risk: nutrients for prevention of thrombotic disease. Semin Thromb Hemost. 2011 Apr;37(3):199-208. Epub 2011 Mar 31.
(3) Vay Liang W. Go, Debra A. Wong, Melissa S. Resnick and David Heber, Evaluation of Botanicals and Dietary Supplements Therapy in Cancer Patients. Journal of Nutrition
(4) Heber D. Blackburn G. L. Go V.L.W. eds. Nutritional Oncology 1999 Academic Press New York, NY.
(5) Sam Schulman, M.D., and Per Lindmarker, M.D. for the Duration of Anticoagulation Trial
Incidence of Cancer after Prophylaxis with Warfarin against recurrent venouse thromboembolism. N Engl J Med 2000; 342:1953-1958June 29, 2000
(6) Baron JA, Gridley G, Weiderpass E, Nyren O, Linet M. Venous thromboembolism and cancer. Lancet 1998;351:1077-1080
(7) Perioperative Herbal Supplement Use in Cancer Patients: Herbal Supplements That Modulate Coagulation in Cancer Patients. Cancer Control 2005;12(3):149-157. © 2005 H. Lee Moffitt Cancer Center and Research Institute, Inc.
(8) Walter J, Handel LL, Brodhun M, van Rossum D, Hanisch UK, Liebmann L, Heppner F, Goldbrunner R, Koch A, Kuhn SA Expression of coagulation factors and their receptors in tumor tissue and coagulation factor upregulation in peripheral blood of patients with cerebral carcinoma metastases. J Cancer Res Clin Oncol. 2012 Jan;138(1):141-51. Epub 2011 Nov 8.

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