Managing thromboembolic disease in the cancer patient: efficacy and safety of antithrombotic treatment options in patients with cancer

Management of thromboembolic disease in patients with cancer can be challenging. Patients with cancer who have established thrombosis are at increased risk of recurrent VTE and of anticoagulant-associated bleeding compared to patients with no cancer. The optimal treatment of VTE in patients with cancer should lower the risk of recurrent VTE without increasing the risk of bleeding and ideally improve a patient's quality of life. Initial treatment of VTE in patients with cancer should be with LMWH, which may be administered, subcutaneously, at home. The current standard of care for long-term treatment of VTE remains oral anticoagulant, which should be administered for as long as the cancer is active. However, the use of oral anticoagulants can be problematic in these patients due to possible anorexia and vomiting. The efficacy and safety of long-term treatment of VTE in cancer patients with LMWH is currently under investigation.