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.
cave76
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.)
********************************
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?
*** 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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My doctor is convinced my PE was unprovoked, saying that being on the pill and going on a flight over a month before initial symptoms began were too minor and he was not going to rule anything out even cancer. I was told I couldn't have lung cancer as it would have been evident on the CT scan but they needed to do an abdominal scan. To know that there was a small chance (5% i was told) that I had some unknown cancer was devastating.. and when I was told about it it just added to my already existing anxiety and made it so much worse. I goggled my symptoms a lot and if I believed what I read I could have diagnosed myself with every cancer under the sun!.. this is why we should not google stuff, there is way too much negative stuff out there!
..Anyway I had to wait a couple of months to have an abdominal scan.. in the mean time I ended up back in hospital as I developed a minor case of phenomena. I told the doctor in hospital about the cancer blood tests and scan I was due to have and he was shocked and said in a patient my age (22) this is something he personally would not look for, it was completely unnecessary. This reassured me a little but didn't take away my fear completely.
Whilst I was quite sure I didn't have cancer, everyday it was in the back of my mind.. WHAT IF!?
Had my scan on Friday and thank god everything is fine :o). I almost cried when they told me. It was like a huge weight had been lifted and now its one less thing for me to worry about and I finally feel like I can get on with my life.
Fact is we must all already (PE or no PE be at risk of developing cancer, its a fact of life) I know I would have never have even thought about cancer until my doctor mentioned it.
I just wish (whilst you could argue its best to know) if the risk of PE being caused by cancer is so low, why check for it?.. why put people through the stress? It was stress I know I personally could have been without.
PE is one of the hardest things we'll ever have to get through through, so lets concentrate on the positives!..
If we use this "negative" line of thinking most of us would have to censor ourselves here. For instance, most people who are on warfarin for 6 months are terrified to come off of it because they're so worried about clot re-occurrence. Does that mean that those of us who've had re-occurrences shouldn't post our experience or mention it because we don't want them to be disturbed or distressed by that? Of course not.
On this site, we do support each other but we also share information. The information may or may not be helpful or useful to all. But it may be to others. I am not a fan of statistics and studies myself because they to me remove the human element from the equation. They just don't really tell the whole story. And for every study that says one thing, there often seems to be another study to contradict it. And frankly, if I hung my hat on every study and statistic, I'd be dead by now. But others may find them of interest or it may spark a discussion between them and their doctor which is important.
Given how much I post here and how I'm always lippin' off, you'd think I read every single post here. I don't. If it looks like it may not interest me or that all that can be said has been said, I move on.
But I am a big fan of reading ALL the information I can that might help me understand something---- especially about my health. That includes reading what everyone has to say here (or any forum)---- plus studies that are specific to what I need to know more about.
The forums give me the human element. Thanks to all of you here.
The studies give me food for thought that perhaps others don't know (or maybe they just don't want to know, which is o.k. "for them", but not me).
I will post them here. It's my way of trying to help.
"Science articles" are neither negative or positive. By the very definition of 'science' they can't be. They just "are" and they're waiting to be revised by another study performed under the same rigorous standards and they must be able to be repeated. If it can.
If a particular study is considered false then there a hundreds of other scientists and grad students just waiting to leap all over it and prove that THEIR study is correct. Talk about a bunch of squabbling old ladies. (grin) Read the medical journals and then read all the 'letters' that follow. Sheesh!
I love it. Science never stands still.
I read every study with a grain of salt----as should everyone. But a study is not, can not be negative or positive. That's in the mind of the reader. It can only be right or wrong, repeatable or not repeatable, proven or not proven---- but usually a mix of those.
Some studies become permanent---- like the world is round. (grin)
The world is round... is the science in on that one yet?
Earatosthenes
Aristarxus
Magellen
Pythagoras
Columbus---- but he got lost so who knows how he did
But bringing this up to modern times---- how 'bout the astronauts who actually saw it from afar?
But the Flat Earthers still abound. Guess they'll never be convinced. LOL
I'm sorry what your doctor said upset you. But take it in this context:
Doctors HAVE to warn their patients about possible consequences. If they don't they can be called up before the medical board if, by some weird set of circumstances, a patient wasn't warned. Those 'weird' circumstances might be a cancer that had been 'lurking' in a patients body for years an was undetectible by the normal blood tests most people have.
Hypothetically----- that patient could developed cancer, find an attorney that would take their case and that attorney would drag up every case in the world where a person with clots developed cancer!!!!
HYPOTHECTICALLY!
The doctor could be sued and found guilty of not 'informing' his patient of possible consequences.
I'm about as tough on doctors as anyone I know----- but I do know enough about their profession that doctors are very vulernable at all times for malpractice suits and I can feel sorry for them at times for this very reason.
Try to think of it as being ethical. IF he demanded that you be tested for cancer, say a colonoscopy in a clinic that he owned---- THAT'S unethical! But it sounds as if he just gave you the information, as he should, and dropped it.
I don't know the entire story, of course, but from what you told us---- that's my take on it.
Here's just one case in NJ which is on the same subject (no warning ) but NOT about clots.
"NJ Allows malpractice claim for not warning child of parent's genetic predisposition to cancer"
p.s. of course not even ethical doctors do take the time to 'warn' of consequences. If they did, the time of appointment would have to be an hour, at least!!! That's where people have to do the research themselves.
Just reading everyone's stories has helped a great deal already. I'm so glad that I stumbled upon this site. To have other people to "talk" to that are going through the same things that I am has helped tremendously!
If your hematologist REALLY suspected a malignancy, he'd be running tests to determine that.
If doctors have a strong suspcision of something, they will test for it.
It's very hard to not think of the unknown, I think it's natural for us to do that, but you have to also be able to balance that with what is known.
Don't spend too much time worrying about what MIGHT happen, it is totally a drain on you.
((hugs))
Over the three months since my PE, I have been very re-assured by several posts on this site, such as JMac's within this thread, which have stated that medical experts dealing with PEs on a daily basis do not see many patients with unprovoked PEs who have previously asymptomatic cancer as the root cause. Equally, both my own doctor and the consultant who I saw at the hospital on Thursday said that even when it is the case, the cancer is normally at such an early stage that it is eminently treatable and patients invariably make a full recovery.
I'm being scanned next month in order to rule it out but only after great insistence and pulling a few strings with people who I know. In the UK, it is not done as a matter of routine after an unprovoked PE, unless the patient is symptomatic of cancer. That in itself tells you that it must be very low on the list of possible causes.
Keep positive.
Yep!
****Keep positive.****
Yep!