Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
First the scary study:
*** Patients with pulmonary embolism who had cancer, congestive heart failure, or chronic lung disease had a higher risk of dying within one year than did other patients with pulmonary embolism***
(N Engl J Med 1992; 326:12405.)
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Then a much more scientifically and larger conducted study:
****Over 100 years ago, Trousseau reported cases of episodic migratory thrombophlebitis in patients with cancer.2 The pathogenic mechanisms for the association include hypercoagulability due to activation of clotting by tumor cells, vessel-wall injury, and stasis.1 Occasionally, the thromboembolic event occurs before the diagnosis of cancer, and it has been suggested that deep venous thrombosis may be a predictor of the subsequent diagnosis of cancer; this idea is controversial, however. Several studies have indicated an association,3-7 but others have not.8,9***
****The existing studies are thus limited in size, and few are population-based, which limits the general applicability of the results.***
***Several small studies have indicated an association between deep venous thrombosis or pulmonary embolism and a subsequent diagnosis of cancer, but the subject is controversial.****
****CONCLUSIONS
An aggressive search for a hidden cancer in a patient with a primary deep venous thrombosis or pulmonary embolism is not warranted.****
http://www.nejm.org/doi/full/10.1056/NEJM199804233381701
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This isn't to say ignore any possible signs of other conditions (cancer included).
But I've seen it happen so often: One study is published and somehow becomes the most quoted one regardless of how sloppy the study was crafted or what agendas the studys authors had behind them. (Like did a cancer hospital fund the study?)
And how many of those patients already had cancer lurking in their body?
*** Patients with pulmonary embolism who had cancer, congestive heart failure, or chronic lung disease had a higher risk of dying within one year than did other patients with pulmonary embolism***
(N Engl J Med 1992; 326:12405.)
********************************
Then a much more scientifically and larger conducted study:
****Over 100 years ago, Trousseau reported cases of episodic migratory thrombophlebitis in patients with cancer.2 The pathogenic mechanisms for the association include hypercoagulability due to activation of clotting by tumor cells, vessel-wall injury, and stasis.1 Occasionally, the thromboembolic event occurs before the diagnosis of cancer, and it has been suggested that deep venous thrombosis may be a predictor of the subsequent diagnosis of cancer; this idea is controversial, however. Several studies have indicated an association,3-7 but others have not.8,9***
****The existing studies are thus limited in size, and few are population-based, which limits the general applicability of the results.***
***Several small studies have indicated an association between deep venous thrombosis or pulmonary embolism and a subsequent diagnosis of cancer, but the subject is controversial.****
****CONCLUSIONS
An aggressive search for a hidden cancer in a patient with a primary deep venous thrombosis or pulmonary embolism is not warranted.****
http://www.nejm.org/doi/full/10.1056/NEJM199804233381701
******************************
This isn't to say ignore any possible signs of other conditions (cancer included).
But I've seen it happen so often: One study is published and somehow becomes the most quoted one regardless of how sloppy the study was crafted or what agendas the studys authors had behind them. (Like did a cancer hospital fund the study?)
And how many of those patients already had cancer lurking in their body?
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Look at what my best friend did with my picture!
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We all have 24 hours in a day. How we spend these hours is important. Watching a little bit of a video about how sitting affects us made me aware of how much sitting and laying down I do. Gonna have to work on that.Your turn. Tell me another truth.
*** Patients with pulmonary embolism who had cancer,[...] had a higher risk of dying within one year than did other patients with pulmonary embolism***
----- but I avoid redacting words as much as possible unless it's a long passage.
I put in the subject heading a clue "not so much".
Then I added at the beginning of my post--- "first the scary part" thinking I was cluing people in as to what they MIGHT read about PE and cancer. Evidently that didn't work and I apologize for disturbing you.
The entire post was in response to another member who had a 'scary experience' and a few hours of thinking that he might have cancer. I didn't want to hi-jack his thread so I started a new one which I thought might be interesting.
Plus---- some doctors will frighten PE patients with the really scary idea that if they have a PE they could have undiscovered cancer in their body! That is simply not true (not that it couldn't be so but entirely unrelated to a PE) and I find doctors that do that should be at least have a 'slap on the hands' entered into their record.
After my first PE an arrogant hospitalist, as I was preparing for discharge, came in and wanted me to have a colonoscopy to 'rule out cancer' as a reason for my PE! I declined and he huffed away. (Did I ever mention that colonoscopies are a huge money maker for hospitals??) But I'm digressing, again.
Have I un-confused you, inycrts? I hope so.
http://www.clotconnect.org/patients/what-do-i-need-to-know/i-have-cancer-what-do-i-need-to-know
An interesting note, Dr. John Heit from the Mayo Clinic reported to the American Society of Hematology the results of the largest study to date regarding blood clot occurence here in the U.S.. One of aspects shown in his study was, many cancer patients actually died of a PE, not the Cancer itself. This was found during autopsy. In the past, the cause of death would have been ruled as cancer but this study brought new attention to the risk of DVT relating to cancer patients.
Here is some more information from the stoptheclot website where my good friend Liz discusses the topic of cancer and blood clots also:
http://stoptheclot.org/faq/faq_blood_clots_cancer.htm
New England Journal of Medicine Recent study shows a 53% reducion in mortality for those have polyps removed during colonoscopy. I've just passed the two month mark for Warfarin but I intend toask my doctor if I can go off taking at the 3 month mark. I've had some symptoms that kind of bother me right now. I would kind of like to know if anything might be going on.
http://www.medscape.com/viewarticle/759014
Regarding cancer and PE, I was told that if you have an unprovoked PE (meaning that you hadn't had recent surgery and hadn't been on a long flight and it didn't appear to run in your birth family, etc.) that they look for cancer. In my case, they did a pelvic and abdominal ultrasound and only examined my breasts physically since I had had a mammogram within the last year. I had had a colonoscopy years before where a benign polyp was found and they did suggest that I get another colonoscopy when things settled down after my PE diagnosis.
I am clear now about why you posted all of this now, but for me that info. regarding lung disease and CHF has been quite upsetting.
I'm the type that wants to know everything--- good, bad and ugly. Not everyone is like that. But I won't stop presenting different sides to an issue and will apologize to you in advance. I hope you'll accept my apology.
Thanks to stoptheclot for that article about cancer and PEs.
The study I quoted said that the subject is controversial. Which makes the other quote I posted bear some weight also.
Which is right? Which is wrong? I don't have a clue. But I do know that I like to read both sides.
****CONCLUSIONS
An aggressive search for a hidden cancer in a patient with a primary deep venous thrombosis or pulmonary embolism is not warranted.****
Statistic do not tell NEARLY the entire story. We are not statistics; we're individuals, whose health should not be summed up in a percentage, or a case study. And stats do not take into account variables in each person's over all health and specific situation. It's just data.
I think what we need to do as patients is express concerns about malignancy, if there is one, and if you have one of these diseases,ask your doc if tests are warranted to rule out cancer.
I have ulcerative colitis and that means I technically have a 20% higher rate of developing colon cancer. What can I do except go for my regular colonoscopies, stay on top of my disease and live the best life that I can.
***she said it is very very rare as it is more normal to be showing some signs or symptoms before the clots are an issue. hope this gives reassurance to you all ***
Thank you. That's what I posted implied--- actually really did say. I'm glad to hear that you've found that out by another route.