Blood clots: How to minimise your risk.

A blood clot (or VTE - venous thrombo embolism) is unfortunately more likely to occur in people with cancer (5-7x more likely). If left untreated these can be very serious and can cause death. There is no way to sugar coat this - you’re 3x more likely to die of a blood clot in the lung compared to someone who doesn’t have cancer.

Sorry, I know that opening statement is a bit doom and bloody gloom but it is really important to know that you’re at an increased risk so that you can do things to try and reduce this risk.

What symptoms do you get with a blood clot? This depends on where it is.

Leg or Arm - pain, redness, heat and/or swelling of area - this is called a deep vein thrombosis (DVT).
Lung - pain, breathlessness, fast heart rate and/or coughing up blood - this is called a pulmonary embolus (PE).
Brain - headaches, changes in vision, dizziness, weakness or numbness of anywhere in the body - this is basically a type of stroke.
Heart - chest/jaw/arm pain, breathlessness, nausea, pins and needles (these symptoms are normally worse or appear when exercising) - this is essentially angina or if severe could be a type of heart attack.
Abdomen/pelvis - abdominal pain (can be worse after eating).

IF YOU DEVELOP ANY OF THESE SYMPTOMS SEEK MEDICAL ATTENTION IMMEDIATELY!

Why does cancer increase your risk?

It’s not fully understood but there are lots of reasons why it might - there is a very in-depth article you can read here - but my take away is that the cancer is causing all sorts of trouble, making your blood thicker, damaging blood vessels and just making clots more likely.

There are certain cancers that mean you’re at an increased risk;

Pancreas
Uterus (womb)
Lung
Stomach
Kidney
Brain

There are certain cancer related things that mean you’re at an increased risk;

The more advanced your cancer is the higher the risk.
Straight after diagnosis is the time period where your risk is highest of developing clots (it’s thought to be because you’re most likely to have tests done and treatments at this point).
After surgery (especially with pelvic or abdominal surgery) - being immobile can increase your risk.
Chemotherapy - certain drugs can increase your risk (brilliant).

Non cancer related risk factors;

Age - the older you are the more at risk you are.
Comorbidities - the more medical problems you have, particularly obesity, kidney disease, heart disease, lung disease and acute infection the more at risk you are.
Race - black people are more likely than white people who are more likely than hispanic people to have blood clots. Asian/pacific islanders have the lowest risk.
Immobility - or reduced mobility (if you’re not very active.
Previous blood clot.
Smoking.

So now we’ve gone through all that seemingly depressing information, what can you do to try and reduce your risk?

Stop smoking!
If you’re a smoker there is help and support and a whole world of products out there. You can try tablets or nicotine replacement. It depends on your preference but I normally encourage patients who want nicotine replacement to have a patch - this gives your some background nicotine and should reduce your cravings, along side something that you can take and get an instant nicotine hit for when you find yourself reaching for the cigs - this could be gum, an inhalator, a lozenge, a melt, a spray etc.
See here for details.
Move more!
Exercise is fabulous for so many reasons, it can also reduce your risk of developing blood clots. It gets your blood moving around your body, your lungs working, heart pumping, which all reduces the risk of blood clots. If you’re staying still, either because you’re working at desk, binge watching a series on Netflix, you just can’t face getting out of bed, you’re not moving those calf muscles. Your calf muscles contracting and relaxing is what moves the blood from our lower legs back up into the rest of our body. If your calf muscles are not being used for a long period this means the blood is staying still, which can lead to blood clots forming.
Walking, is a brilliant way to help pump those legs.
If you don’t want to do that much moving, then calf raises - where you stand up on your tip toes and back down again can help.
If that’s too much - raise your legs up off the bed or sofa and make ankle circles.
Cycling - some people use mini exercise bikes where you just turn your legs if they find themselves on the sofa for long periods of the day.
It doesn’t matter what exercise it is as long as you’re moving those legs and try and do some form of movement every 30mins-1hr, if that is getting up and going to the toilet or getting a glass of water/cup of tea, that’s a okay.
Here are some studies about exercise and bloods clots here, here and here.
Compression socks!
These work by gently squeezing your legs and helping with blood flow. They can also help with pain and swelling if you’ve developed a blood clot (but speak to your specialist before using them if you have got one).
I bought some here - the customer service was fantastic, they rang me to check my measurements, the socks were comfortable and dare I say stylish. I would wear these on the days I was having chemotherapy, every night (chemo or no chemo), if I was going on a long journey either by car or train (if I had flown during my treatment I definitely would’ve worn them) and after surgery.
Keep those feet up!
If you’re lying down in bed or on the sofa, having your feet slightly higher than your hips, by putting a pillow/cushion/blanket underneath them will help return blood to the rest of your body thanks to gravity. Having your feet on a foot stool that is lower than the level of your hips will not help!