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      Cancer and Venous Thromboembolic Disease: A Review.

      1 , 2

      The oncologist

      Alphamed Press

      Cancer, diagnosis, treatment, venous thromboembolism

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          Abstract

          Venous thromboembolism (VTE), including deep-vein thrombosis and pulmonary embolism, represents a major cause of morbidity and mortality in cancer patients. Patients with cancer are six times more likely to develop VTE than their noncancer counterparts, and VTE is the second leading cause of death in cancer patients. Despite the publication of major consensus guidelines setting out recommendations for thromboprophylaxis in cancer patients, there remains a gulf between these guidelines and clinical practice. In general, thromboprophylaxis is recommended for most patients hospitalized with active cancer. Furthermore, outpatient thromboprophylaxis may be used in carefully selected high-risk ambulatory patients. Certain areas of controversy still remain. Although low-molecular-weight heparin has been shown to be superior to vitamin K antagonists in cancer patients, the role of direct oral anticoagulants is still uncertain. Moreover, recurrent thromboembolism, bleeding, and thrombocytopenia are frequently seen in cancer patients. Optimal anticoagulation in such instances presents a major challenge to clinicians. Modern computed tomography techniques have resulted in an increase in the detection of "incidental" VTE. Despite a growing body of evidence promulgating standard anticoagulant treatment in such cases, these cases present further challenges for members of the multidisciplinary team. The Oncologist 2017;22:199-207Implications for Practice: This article discusses venous thromboembolism (VTE) in patients with malignancy. Practical guidance is offered on how to prevent, diagnose, and treat VTE in cancer patients. The management of "challenging" cases of VTE is also discussed.

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          Author and article information

          Journal
          Oncologist
          The oncologist
          Alphamed Press
          1549-490X
          1083-7159
          Feb 2017
          : 22
          : 2
          Affiliations
          [1 ] Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
          [2 ] Department of Hematology and Oncology, Cleveland Clinic, Cleveland, Ohio, USA khorana@ccf.org.
          Article
          theoncologist.2016-0214
          10.1634/theoncologist.2016-0214
          5330704
          28174293

          venous thromboembolism, treatment, diagnosis, Cancer

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