Management of venous thromboembolism in cancer patients

Venous thromboembolism is a common complication in patients with cancer. Th e management of deep-vein thrombosis and pulmonary embolism can be a consid erable challenge in these patients. Diagnosing venous thrombosis requires o bjective testing, and noninvasive investigations may be less accurate in pa tients who have cancer than in those who do not Treatment of acute venous t hrombosis at home with low-molecular-weight heparin is an attractive option in patients with malignant disease, in whom quality of life is especially important. Comorbid conditions, warfarin resistance, difficult venous acces s, and a potentially high bleeding risk are some of the factors that often complicate the prolonged course of anticoagulant therapy needed in this gro up. lit addition, the use of central venous catheters is increasing, but th e optimal treatment of catheter-related thrombosis remains controversial. T his article reviews the current diagnostic and treatment approaches to veno us thromboembolism in patients with cancer and provides several clinical sc enarios to illustrate and discuss some common management problems.