Blood clots and cancer

My grandmother developed phlebitis (blood clots and inflammation in the veins of the legs) in her mid sixties. She was treated for the clots, however clots were treated in the 1960's, and no further investigations were undertaken. Within a year, she was dead from metastatic ovarian cancer.

So when my very healthy (tanned, fit) fifty-something patient came in with tender, swollen veins in her right calf, I thought of Grandma and alarm bells went off. One week of testing later, the results showed metastatic pancreatic cancer. She too was dead within the year.

My Mom always felt guilty that she hadn't pursued further work-up for her mom after those clots popped up. A study in the Archives of Internal Medicine suggests that prompt follow-up wouldn't have helped Grandma any better than it did my unfortunate patient.

Over half a million cancer cases were culled from the California Cancer Registry to identify cases of common malignancies correlated with spontaneous blood clots. While the incidence of blood clots preceding localized cancer was not significantly elevated, the risk of being diagnosed with metastatic cancer post-phlebitis was more than double.

So no guilt here for cancers discovered after the clot-fact. Per the authors, "Given the timing and advanced stage of the unexpected cases, it is unlikely that earlier diagnosis of these cancers wwould have significantly improved long-term survival.