Description
Venous thromboembolism (VTE) in patients with advanced cancer may be particularly difficult to manage. There is a wide spectrum of symptoms; variable access to diagnostic facilities; and ambivalence regarding the appropriateness and safety of anticoagulation. Thus, the prevalence of VTE is probably underestimated in the palliative care setting. Potentially erratic INR control requires frequent monitoring, which impinges significantly on quality of life. The decision to anticoagulate or not becomes increasingly difficult with advancing disease. Management of such patients remains individually tailored, but the advent of low molecular weight heparins offers a treatment option where anticoagulation would have previously been deemed inappropriate.
