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.
DVT + PE = VTE
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 nuerosurgery, 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 'pulmonay embolism' to my List of Cancer Curveballs. It occupies position 4 in my cancer chronology.
List of Cancer Curveballs
Number 1: having a floppy sigmoid
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 about 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 scars, tattoos and the fact I can poo in any position (courtesy of the bag).
Posted by benbravery at 7:48 PM