Blood Clots In Cancer Patients – What Are The Risks?

“You have cancer.” These are the last words that anyone wants to hear from their doctor. Yet hundreds of thousands of people are given this diagnosis every year. Thankfully, researchers and doctors have made great advances in medicine, which means that more cancer patients are successfully treated and are able to return to their everyday lives.

The treatments are not easy, however, and there are always risks. For the majority of cancer patients, blood clots are one of the most dangerous risks associated with both the disease and the available treatments.

Types of Cancers That Place Patients At Higher Risk

All patients that have been diagnosed with cancer are at risk for forming blood clots, but certain types of cancer have a higher risk than others. These include:

  • pancreatic
  • bowel
  • lung
  • stomach
  • ovary
  • uterine
  • blood

Why Does Cancer Increase The Risk of Blood Clots?

There are a number of factors that result in a higher risk of developing blood clots in cancer patients.

First, cancer patients typically have a higher number of platelets and clotting factors in their blood. Due to a decrease in protein, the body also tends to produce fewer anticoagulants.

Second, the treatments for cancer, specifically chemotherapy, can cause damage to the blood vessels which results in an increased risk of blood clots.

Third, most cancer patients are so ill that they have a reduced activity level. Inactivity is a major risk factor because when the muscles aren’t moving, they aren’t helping the body pump the blood back to the heart.

The last thing that anyone fighting cancer needs to worry about is another life threatening condition. This is why doctors routinely place their patients on blood thinners throughout the course of their treatment.

Medications Commonly Used To Prevent Blood Clots

Blood thinners are the most often used clotting preventative. There are two types of blood thinners:

  1. Anticoagulants – this type of blood thinner works to slow down the chemical reactions that cause a blood clot to form.
  2. Antiplatelets – these drugs prevent blood clots from forming because they prevent platelets from clumping together.

The most commonly used drugs in these two categories are Warfarin,  Heparin, Fragmin, Lovenox, and one of the newest, Xarelto.

Xarelto: A Brief History

Xarelto, which is manufactured by Bayer AG and Janssen Pharmaceuticals, was made available to the medical community in 2011. The drug was approved by the U.S. Food and Drug Administration that same year.

Physicians everywhere were thrilled when they learned of the drug for several reasons, the most important being that it was a “one size fits all” dosage. The manufacturers had finally created a blood thinner that has the same dose for every patient. This is not the case with other blood thinners. Older blood thinner’s dosage is often changed, because certain factors could impact how the drug interacts with the body. These factors include age, sex, diet, weight, and exercise level. Doctors require patients to return frequently for blood work to determine if the dosage is correct – sometimes as often as once a week. So when they were told that Xarelto was the same dose regardless of these factors, excitement levels rose. 

Physicians began to inform patients about the drug and soon had prescribed it to thousands. When given the option of being allowed to return for rechecks on a less frequent basis, many people enthusiastically embraced the option and opted to take Xarelto.

Unfortunately, many of those patients discovered that this decision changed their lives not for the better, but for the worse.

The Dangers Associated With Xarelto

Xarelto has several risk factors associated with it, the most dangerous being that it has no known antidote. What does this mean? If a drug has no known antidote, it means that medical professionals are unable to reverse the effects of the drug. With other blood thinners, doctors are able to administer Vitamin K to the patient in the event of an emergency, to prevent them from bleeding out.

Patients that suffer from any sort of bleeding while on Xarelto, whether it be internal or external, are at risk for severe blood loss due to their inability to form a clot. In order to treat them, doctors must perform blood transfusions. Even this isn’t always successful.

The FDA has also released two black box warnings for the drug. The first indicates that patients who discontinue Xarelto too quickly are at risk for blood clots and deep vein thrombosis (DVT). The second informs the public that anyone undergoing a spinal procedure, or who suffers from spinal trauma, is at risk for a spinal hematoma.

Patients have also reported liver dysfunction, rectal bleeding, pulmonary embolisms, brain hemorrhage, stroke, and gastrointestinal bleeds.

Xarelto Lawsuits

In January of 2014, the first Xarelto lawsuit was filed. Since then, nearly 3,000 plaintiffs have filed complaints, each one alleging that:

  • the manufacturers failed because they didn’t inform the medical community or the public about the risks associated with the drug
  • that the drug has a design defect because there is no way to reverse the effects of the medication, and
  • that the manufacturers were negligent because they allowed the drug to go onto the market even though they knew there was no antidote.

Complaints are filed either by the patient themselves or by the loved ones of a patient who passed away due to complications from using Xarelto. Plaintiffs are seeking compensation for medical expenses, loss of earnings, and funeral or burial expenses.

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