Blood clots in a vein (DVT) and pancreatic cancer
A blood clot forming in a vein is known as venous thrombosis, and if it forms in a vein that’s deeper in the body it’s called deep vein thrombosis (DVT).
Does having pancreatic cancer increase my risk of a blood clot?
People with pancreatic cancer may be at higher risk of a blood clot. The increased risk is caused by your cancer and cancer treatment but it will not affect your treatment.
Most blood clots can be successfully treated. It’s important to know what the symptoms of a blood clot are, and tell your medical team as soon as possible if you have any of these symptoms.
What is a blood clot?
Blood clotting (or coagulation) helps to stop the bleeding when a blood vessel is damaged. It does this by forming a scab over the cut. Blood clots are formed from platelets (blood cells) and fibrin (a type of protein) in your blood. These clump together to help the blood to clot.
Sometimes, a blood clot can form in a vein, which isn’t normal. It often happens in deep veins (DVT) in the lower leg (calf), thigh or pelvis. This can block the normal flow of blood through the veins. A blood clot may travel in the blood stream to the lungs, where it can lodge in the very small blood vessels. This is called a pulmonary embolism (PE). It is not common but it can be very serious. Most blood clots can be treated with blood thinning (anticoagulation) drugs.
Common symptoms of a blood clot in a vein
Symptoms of deep vein thrombosis (DVT) include:
- pain, swelling or tenderness in your arms, legs or calves
- warm skin in the affected area
- a heavy ache in the affected area
- the skin may look red, particularly at the back of the leg below the knee.
Symptoms of pulmonary embolism include:
- shortness of breath, which can start suddenly or gradually
- sudden pain in your chest (especially when breathing in)
- coughing – usually a dry cough but can include coughing up blood or mucus containing blood
- extreme tiredness
- feeling dizzy, lightheaded, or fainting.
Bloods clots do not always cause symptoms. If you do get any of these symptoms, tell your doctor or medical team straight away.
Why are people with pancreatic cancer more at risk of getting a blood clot?
There is a higher risk of getting a blood clot if you have cancer. If you have pancreatic cancer the risk is even higher, and people with advanced (metastatic) pancreatic cancer are particularly at risk.You may be at higher risk if you:
- are having cancer treatment
- are over 60 years old
- have a condition called thrombophilias (where the blood is more likely to form clots)
- are obese
- have had a blood clot before, or a family history of blood clots
- use a contraceptive pill that contains oestrogen
- have varicose veins (swollen and enlarged veins) with phlebitis (an inflammation of a vein).
Some chemotherapy drugs or surgery for pancreatic cancer (such as the Whipple’s operation), can increase the risk of developing a blood clot. Being less active or moving around less after surgery or treatment can also increase the risk of a blood clot.
How is a blood clot diagnosed?
If your doctor thinks you have a DVT, you will usually have an ultrasound scan of the affected area. This is called a ‘Doppler’ and looks at the flow of blood through blood vessels. You may have a computed tomography pulmonary angiogram (CTPA) to diagnose a pulmonary embolism. This is a type of X-ray that looks for the clot in the blood vessels in the lungs.
Risk of blood clots if you go into hospital
If you’re staying in hospital, you will be moving around less and should be given information about how to reduce the risk of a blood clot, and be assessed regularly. You may be given stockings to wear to improve the blood flow in your legs. The nurses will get you moving as soon as possible after surgery. You may also be given a drug to thin the blood, which helps to reduce your risk of developing a clot.
Drink plenty of water so you don’t get dehydrated. If you are not able to move around much, try doing simple foot exercises, such as bending and straightening your toes.
What if I am having chemotherapy or radiotherapy?
People having chemotherapy or radiotherapy for pancreatic cancer do not routinely get medication or stockings to reduce the risk of clots. This is because stockings can cause problems with dry skin. If you have any symptoms, tell your medical team. Remember to move around as much as possible, and drink plenty of water to avoid getting dehydrated. You should be given information on ways to reduce the risk of developing blood clots.
Blood clots are linked to having cancer and cancer treatment, and can be managed without stopping your cancer treatment. If you do develop a blood clot, you will be given the standard blood thinning (anticoagulation) drugs. There are many types of blood thinning drugs. The drug most often used for people with cancer who develop a DVT or pulmonary embolism is called low molecular weight heparin (LMWH). It reduces the risk of more clots forming but there is still a small chance that the clots could get bigger, or more clots could develop. So if you notice that your symptoms are getting worse, contact your medical team.
Your blood thinning drug is usually given once a day as a small injection into the tummy area for six months. District nurses are able to give you the injections in your home, and you or a family member may be shown how to inject it. You may have it for longer than six months, and some people may have it for the rest of their lives.
If you are not currently having chemotherapy, you may be able to having blood thinning tablets instead. Your doctor may need to monitor you to get the dose right.
Sometimes, different blood thinning drugs are used, depending on your own situation. Ask your doctor about other options if you are having problems with LMWH injections.
Side effects of blood thinning drugs
The main side effect of blood thinning (anticoagulant) drugs is bleeding, because the medication increases the time it takes for blood clots to form. For example, you may notice that you bleed a bit more if you have a nose bleed or a cut. You may also get bruises in the area where the injection is given. Speak to your medical team about the side effects of the treatment before you start it.
You should be given an information sheet about blood thinning drugs so you know what to expect, including how to take the drug, the side effects and when to get help. You should also be given an anticoagulation drugs alert card to carry with you at all times.
If you have any questions about blood clots, speak to our specialist nurses on our free Support Line.
Published July 2017
Review date July 2019