Major new study could save people with advanced cancer from unnecessary treatment

A major new study co-published by University of Hull researchers could save thousands of cancer sufferers from the stress of unnecessary medical treatment for blood clots.

The research, which has been published in prestigious medical journal The Lancet Haematology, challenges current thinking and shows the treatment of blood clots may not be needed for a large portion of cancer patients as they are not associated with serious symptoms or survival.

Professor Miriam Johnson, Professor of Palliative Medicine at Hull York Medical School and Director of the Wolfson Palliative Care Research Centre at the University of Hull, said:  “Our research has major implications for those cancer patients with far advanced disease who – while they may have blood clots in their legs, or be considered at risk of getting one – do not need to receive tablets or injections to treat or prevent one.

“It is our sincere hope that by driving improvements to healthcare practice we will be able to save patients the distress of unnecessary treatment at this stage of their lives."

The study, in The Lancet Haematology1, has shown that around one-third of patients with advanced cancer*, admitted to specialist palliative care units (SPCU) had a blood clot in the main vein of the leg (femoral vein deep vein thrombosis, or DVT).

Despite current thinking, the clots did not appear to shorten life, or be associated with clinically significant symptoms.

People more likely to have a DVT on admission were those who had had a DVT in the past, or who had been bedbound at any point during the previous 3 months. However, very few without a DVT on admission developed a clot during their stay. 

The longitudinal multicentre study, led jointly by researchers at the Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull and Northern Ireland Hospice, Belfast in conjunction with co-investigators at the Marie Curie Palliative Research Centre, Cardiff University, is the first to demonstrate the true extent of the problem in people with advanced cancer and the impact on patient outcomes. DVT is the most common preventable cause of hospital death and prevention of hospital acquired thrombosis is a major health service focus and patient safety issue. People with cancer are at particular risk of DVTs and clinical guidelines recommend preventative medication for all with cancer if admitted to hospital unless there is a contraindication to anticoagulation or the patient is thought to be imminently dying. However, until now there have been no accurate figures for people with advanced disease admitted to SPCUs or information about the impact of DVTs on symptoms or survival.