CANCER, THROMBOSIS AND HEPARINS: CURRENT STATE OF THE ART
Cancer patients are at high risk of thrombotic complications including deep vein thrombosis and pulmonary thromboembolism. These complications contribute to poor outcomes of cancer treatment and are a leading cause of cancer deaths. According to ASCO guidelines all hospitalized cancer patients are considered candidates for anticoagulant prevention of deep vein thrombosis and pulmonary thromboembolism unless they developed hemorrhage or had other contraindications. Analysis of many-year results of anticoagulant prevention and treatment of thrombotic complications demonstrated improved survival of cancer patients. Basing on multiple experimental and clinical studies thrombosis and cancer were found to have many pathophysiological links. Occurrence and growth of cancer is associated with persistent activation of blood clotting (hypercoagulation) system and increased risk of thrombosis, while hemostasis unbalance associated with tumor growth contributes to disease progression. Components of the blood clotting system together with cancer cells and their metabolites are involved in tumor angiogenesis, growth and metastasis. It follows then that fibrin inhibition should be considered a way to inhibit cancer progression.