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The challenges of managing cancer related venous thromboembolism in the palliative care setting


Cancer patients with venous thromboembolism VTE pose particular management challenges since they have an increased risk of bleeding and recurrent thrombosis compared to the non-cancer population. Also, as the disease progresses so do the hazards of anticoagulation, and patients in the palliative stages of their cancer could be viewed as a separate disease group with respect to diagnosis and management. As the focus from curative treatment moves towards symptom control, physicians face several challenges in providing the most appropriate care. Palliative care patients have rarely been included in research on VTE and the supporting evidence needs to be extrapolated cautiously. Quality of life aspects of VTE and their management may be a more appropriate outcome measure in this stage of disease than radiological end points. This paper looks at the challenges facing professionals in the management of VTE in the advanced cancer patient.

  • cancer
  • hospice
  • low molecular weight heparin
  • LMWH
  • palliative care
  • venous thromboembolism

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  • Competing interests: None

  • Abbreviations:
    computed tomographic pulmonary angiography
    deep vein thrombosis
    international normalised ratio
    Long-term Innohep Treatment evaluation
    low molecular weight heparin
    pulmonary embolus
    Specialist palliative care unit
    venous thromboembolism
    V/Q scan
    ventilation/perfusion lung scintigraphy