Chemotherapy and cerebrovascular disease

Cerebrovascular disease is common in cancer patients. Some tumors are at high risk for cerebrovascular complications. The development of cerebrovascular disease may be provoked by cancer treatment. No well-planned prospective studies about other causes of thrombosis are available, although various case reports about thrombosis related to chemotherapy have been published. L-asparaginase, cisplatin, 5-fluorouracil (5-FU) and methotrexate are anticancer agents which are reported to relate to stroke. The mechanisms by which antineoplastic agents may lead to stroke include endothelium toxicity and abnormalities of coagulation factors. Also, brain hemorrhages that could result from chemotherapy effects on the hemostatic system were reported. Besides, it is difficult to determine whether stroke is caused by chemotherapy or cancer itself. Clinicians deal not only with problems originating from cancer itself, but also with the complications resulting from its treatment. Treatment-induced cerebrovascular disorders affect quality of life and survival in cancer patients. For this reason, cancer treatment should be planned by taking into consideration the possibility of cerebrovascular complications.