Venous thromboembolism and cancer

The association of thrombosis with malignant disease has been recognized fo r well over 100 years. Evidence from experimental and clinical studies indi cates that the haemostatic system is involved in the growth, invasion and m etastasis of tumours. Laboratory parameters of haemostasis are frequently d eranged in patients with cancer and overt thrombosis is common spontaneousl y where it may be the first sign of malignancy or secondary to therapy. The mechanisms by which coagulation activation facilitates the malignant proce ss remain to be completely elucidated, but it is clear that cells and prote ins of the coagulation and fibrinolytic systems are involved at many steps in the processes of tumour growth and dissemination. The low-molecular-weig ht heparins with their well-proven safety and efficacy profiles offer uniqu e modalities for the prevention and treatment of cancer-associated thrombos is. They may also play a role in overall mortality reduction in patients wi th malignant disease.