From: "Dr. Doreen Kossove" <doctordee@wandata.com>
To: "Sarah Dietrich" <DIETRICH72@AOL.COM>; "LMS list" <L-M-SARCOMA@LISTSERV.ACOR.ORG>
Subject: hypercoagulable states and cancer
Date: Friday, December 28, 2001 2:15 PM

Dear Sarah:
I am sorry about your mother's TIA, but thankfully it was just a warning.
I have sent you copies of my disclaimer letters, so you know that I am not
practicing medicine here, just providing information if I can.
I did Pubmed Searches on  *cancer AND strokes*  and  *cancer AND clotting*,
the edited results will be sent to you.  If anyone else wants them, please
contact me.

"An hypercoagulable state is observed in cancer patients, as shown by
abnormal "routine" blood tests found in up to 90% of these patients, as well
as increased levels of specific markers of coagulation activation.
Clinically, these abnormalities are expressed as thrombosis, hemorrhage or
low grade or fulminant disseminated intravascular coagulation. The
pathophysiology of this thrombophilic state is complex and due to
interactions of tumor cells and their products with host cells. Cancer
patients are thus at high risk of thrombosis..." [1]

Definitions & Conditions:

Thrombosis is the formation, development, or presence of a clot[also called
a thrombus].

Disseminated Intravascular Coagulation, or DIC, is a condition in which all
of the clotting elements, factors, platelets & etc., all clot, all at the
same time.  What happens then is that there are NO clotting agents available
because they have been used up, and these people bleed, become covered in
bruises and bleed internally as well.  This condition can present
catastrophically.

However, the more usual presentation of DIC in a cancer patient is a low
grade clotting tendency, with multiple minor episodes.

Paraneoplastic Syndromes: These are collections of symptoms that occur when
people have cancer.  The syndromes differ from person to person and cancer
to cancer.  Often Tumor Secretions play a part.  Development of auto-immune
disease also occurs.

Auto-Immune disease occurs when people make antibodies to their own tissues.
And try to destroy their own tissues.  When auto-immune antibodies are made
to blood vessel walls, either artery walls or vein walls, there will be an
increased incidence of clotting in those vessels.

Trousseau's Syndrome is a migratory thrombophlebitis [inflammation of the
veins associated with clotting] associated with cancer and believed to be an
autoimmune phenomenon.

Endocarditis [inflammation of the inner walls of the heart] that is not
bacterial can occur with cancers,and cause arterial emboli.  We are familiar
with Pulmonary Emboli, the usual cause of which is fragments of clot
breaking off from a large clot in the large vein of a leg.  These fragments
travel to the heart, and pass into the Pulmonary circulation, where they
eventually plug a pulmonary arterial vessel.

Embolus/emboli : A clot or other plug brought by the blood from another
vessel and forced into a smaller one, so as to obstruct the circulation.
Once emboli reach or are generated in the heart, they can travel to any
organ, including the brain.

Tumor growth in the heart chambers or on the valves can also cause
embolization, either of the tumor or of clot that may form around the tumor.
LMS can metastasize to the heart, but this is rare.

Thrombocytosis:  High platelet[thrombocyte] counts in the blood.  Many
cancer patients have high platelet counts, either heralding lung tumors or
as a result of inflammatory conditions.  If the platelet counts get too high
[like 1,000], they actually require treatment to prevent clotting problems.

Dehydration, because of decreased fluid intake due to feeling ill, loss of
appetite, or vomiting, is a
predisposing factor to clotting.

Lack of movement: post operatively, or because of feeling ill, or various
amputations, also predisposes to clotting.

Surgery:  there is a hypercoagulable state after surgery.

~~~~~~~~~
1. Ann Biol Clin (Paris) 2000 Nov-Dec;58(6):675-82
[Venous thrombosis and cancer] [Article in French]
Gouin-Thibaut I, Samama MM.
Service d'hematologie biologique, Groupe hospitalier
Charles-Foix-Jean-Rostand, 7, av de la Republique, 94205, Ivry-sur-Seine.
~~~~~~~~~~~~~~
Just for fun, I will add that there has been noted the development of
Hemophilia in some cancer patients, who developed auto-antibodies to their
Clotting Factor VIII.
~~~~~~~~~~
doreen
with thrombocytosis and paraneoplastic autoimmune phenomena since before the
first surgery. On daily aspirin.
~~~~~
Any correspondence represents the view of a single individual.  The
statements made here are not intended to substitute for,and should not be
construed as, medical advice.  I am not advising you nor recommending any
particular course of treatment.  You should of course consult with your
doctor for any medical treatment.




 