Thromboprophylaxis in the cancer patient

Cancer patients not undergoing treatment and without a history of venous thrombosis do not, as a general rule, require prophylaxis. However, venous thromboembolism is of sufficient magnitude in patients undergoing treatment for cancer for thromboprophylaxis to be routinely employed. The mainstay of primary prevention is low molecular weight heparin, while secondary prevention may require warfarin and in some instances vena cava filters. The duration of prophylaxis should usually last for the period of treatment, except in the case of pelvic or cerebral radiotherapy where it is continued for 4-12 months beyond the treatment period. The principal role for vena cava filters is on occasions where recurrent thrombosis or haemorrhage complicates anticoagulation.