January 10, 2012

Clots and cancer

I have a new life-threatening condition, and it's not cancer. My new condition was picked up in a CT scan done at the end of chemotherapy. This CT was done to re-stage my cancer, but what it actually did was save my life.

I have several blood clots, in the lungs. It turns out that cancer is an independent risk factor for developing blood clots. This means that cancer alone predisposes someone to developing a clot. Cancer treatments like surgery and chemotherapy also increase the chances that someone will develop a clot.


Deep vein thrombosis (DVT) is the name given to a clot that forms in veins in the legs or pelvis. A pulmonay embolism (PE) is a clot in the lungs. Often, clots that form in the legs or pelvis (DVT) travel to the lungs (PE) and taken together these conditions are called venous thromboembolism, or VTE.

Where my clots formed is unknown, but four are now stuck in a mid-section of the left lung. I have no symptoms (for hypochondriacs already asking Dr Google if they have a PE, symptoms would include chest pain, shortness of breath or a fluttering heart beat) and if not for the CT I would be none the wiser (radiologists are some of the unsung heroes of cancer treatment and care).

What is known is that people with cancer are 4 times more likely to develop a blood clot than other people; 20 % of VTEs occur in people with cancer; and developing VTE is associated with a poorer prognosis (depending on the type of cancer).

Clots are more common after abdominal surgery (tick) and neurosurgery, periods of immobilization (tick), and after certain chemotherapeutics such as 5FU (tick). Clots are also more common in overweight (cross) or older people (cross) and people with brain, pancreatic, stomach, ovarian or blood cancers (all crosses). The propensity to develop clots can also be genetic (unknown, testing to follow).

Clotting curve ball

People with cancer get used to curve balls. They come at us from unexpected directions and have a way of sneaking up on us with speed. I'm adding 'pulmonary embolism' to my List of Cancer Curve Balls. It occupies position 4 in my cancer chronology. 

List of Cancer Curve Balls

Number 2: finding out the tumour was bigger than expected and trying to eat other tissues
Number 3: springing a leak in my newly resected colon
Number 4: four blood clots near my lungs

Crushing the clot

I am on a high dose of heparin (a blood thinner) for the next 12 months. I have to inject this myself into my thighs or abdomen. This particular anticoagulant (blood thinner) has a reputation for coming in blunt-ish needles and for stinging like hell and causing bruising. I can confirm all three.

The fact I can now inject myself, knowingly inflict pain and cause impressive bruises all adds to my street cred. These new traits are up there with my scarstattoos and the fact I can poo in any position (courtesy of the bag). 


  1. Cancer curve balls suck. That's awesome though that they identified it and you can do something about it.

    Not that doing something about it sounds all that fun. I was getting two shots of blood thinner a day in my thigh or abdomen when I was immobilised in ICU and they hurt.like.hell. Even when super dosed up on fentanyl. Kudos to you for being able to inflict them on yourself. Amazing... (Yes, I know you do what you have to do, but still...)

  2. You can do it Ben! I had two clots during treatment, but they do not sound as serious as yours. Mine were in my arm and probably caused by the PICC lines. I used to get the deed over and done with each night before dinner, so I could relax and eat my dinner in some sort of peace without the anxiety. Not scared of needles (God knows cancer patients have to get used to that) but I hated sticking myself. Just another curve ball like you said, things will get better

  3. Hey Ben! It's been a while since I've checked back on your blog but I'm all up to date now. This blog is always such an inspiring read, and the news piece on the fun run was particularly touching. It sucks to hear you're being thrown another curve ball, but seeing as you've kicked the other three so well, I'm sure you'll be out of these woods in no time. Sending love all the way from China. ♥ Alex