Summary:
Abstract
Introduction: Thromboembolic disease, which may be the first manifestation of
malignancy, includes deep vein thrombosis and pulmonary embolism, and is one of
the leading causes of death in both hospitalized and ambulatory patients.
However, while lung cancer is the most common malignancy in these patients,
data regarding association of lung cancer with pulmonary embolism is limited.
Numerous studies describe the relationship between cancer and pulmonary
embolism, but do not describe the rate of pulmonary embolism in patients dying
of cancer.
Objective: The investigation of the association between pulmonary embolism and
cancer, and the evaluation of new treatment options based on recently published
guidelines, as well as the retrospective description of the characteristics of
lung cancer patients suffering from pulmonary embolism.
Method: A search through the PUBMED database for articles involving cancer
patients who developed pulmonary embolism during the course of their disease.
Fourteen studies were found matching our search criteria.
Results: The rate of thromboembolic disease ranged between 4% and 20%, but the
rate of pulmonary embolism could not be distinguished, although in a survey,
96% of patients with some type of neoplasm died from pulmonary embolism.
Conclusions: In cancer patients, pulmonary embolism usually presents with
shortness of breath, sweating, tachycardia and chest pain. High rates of
thromboembolism have been reported in patients with neoplasms of the lung,
ovary, brain, pancreas, stomach, kidney and colon. Moreover, in patients with
lymphoma, leukemia and myeloproliferative syndromes, venous thromboembolism is
more common than in patients with other malignancies. Regarding treatment,
anticoagulant factors are considered safe and effective. Available
anticoagulants include warfarin, heparin and low molecular weight heparins
(LMWHs). LMWHs have demonstrated their effectiveness in reducing the incidence
of venous thromboembolism, and can prevent recurrent thrombosis in patients
with cancer, being the most recommended treatment option. If LMWHs are
contraindicated, other therapeutic options are available, such as
unfractionated heparin (UFH). Newer anticoagulants show promise for effective
treatment of venous thromboembolism in lung cancer patients.
