VTE in patients with cancer--diagnosis, prevention, and treatment

Management of venous thromboembolism (VTE) in patients with cancer is challenging. In addition, cancer-associated thrombosis (CAT) is becoming an increasingly prevalent condition because of the aging population, the aggressiveness of anticancer therapies, and the improved survival of patients with cancer. Diagnosis of CAT can be difficult because many cancer patients without acute thrombosis often have with signs and symptoms that mimic those of deep vein thrombosis or pulmonary embolism, while others are found to have clinically silent VTE incidentally on routine staging investigations for their cancer. Prevention of CAT is important for reducing the burden of disease but it has received very little attention from clinicians and researchers. Treatment of CAT is also challenging because oncology patients have a high risk of recurrent thrombosis and major bleeding even while receiving anticoagulant therapy. This review will focus on the current standards of practice for the diagnosis, prevention and treatment of VTE in patients with cancer.