Deep and superficial vein thrombosis

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1. Deep vein thrombosis - blood clots (Thromboembolism)

Patients with malignancy have an increased risk of blood clotting in their veins (thrombosis). The most common veins affected are those in the back of the legs causing a deep vein thrombosis (DVT) but blood can clot in other veins around the body. This tends to cause swelling, redness and discomfort in the area. More, worryingly, particularly in those patients with pelvis, recent surgery or immobility there is a risk that a clot can break off and spread to the lungs (pulmonary embolus). This is a very serious condition and can permanently affect the function of the lungs or even be fatal.

How can you help? Although strategies such as compression stockings and treatments such as warfarin and low molecular weight heparin are essential, lifestyle factors can also reduce the risk of this life threatening complication. Ask your doctor if you could take a low dose of aspirin and the following self help strategies will help reduce the risk of clots:-

• Stop smoking (if relevant)

• Avoid long periods of immobility (one memorable patient recently developed a pulmonary embolus after being stuck on a motorway in a traffic jam!)

• Avoid being overweight - of course, very little can be done to achieve a substantial weight reduction but try to walk briskly at least 20 minutes every day

• Exercise - It’s important to get the blood pumping as much as possible through the veins. General exercises such as walking, running, cycling and dancing as will increase the blood flow but exercising the arm and hand is even more important.  

2. Superficial vein damage and thrombosis

You may experience darkening of the veins in your hands and arms. This is normal, usually doesn't hurt and should fade once your course of treatment has been completed. Of more concern is that towards the end of your chemotherapy course, some veins may feel hard and 'cord-like'. In these veins the blood has clotted (superficial thrombosis) which may take several months to resolve.  

How can you help? Ask your doctor if you could take a low dose of aspirin and as well as the lifestyle factors above two further strategies may help:-

• Hand grip - Various hand grip devices are available commercially but a soft tennis ball, sponge or stress ball will do. Squeeze the hand for five minutes several times a day (without causing pain) this will significantly prevent the blood clotting in the superficial veins. This will not only be more comfortable for you but will help the oncologist specialist find a good vein for the next chemotherapy session. 

• Massage – Using a pure oil such as olive oil rub this over the veins in you arm gently every day – most practically before a shower. This will soften the tissues and render then more compliant offering less resistance to blood flowing through the veins. Contrary to the urban myth there is absolutely no proof or even any underlying theoretic reasoning that massage is harmful in patients with cancer – in fact quite the opposite it is healthy and useful.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.