Venous thromboembolism and palliative care

Abstract

The management of cancer-associated thrombosis (CAT) is largely informed by data from adequately powered randomised control trials. However, their exclusion criteria have invariably rendered the study populations unrepresentative of those seen day-to-day by palliative care practitioners.Recent observational data has given insights into the unique challenges of CAT management within the palliative care setting including the natural history of thrombosis in advanced cancer and end-of-life decision making around anticoagulationDespite developments and some on-going uncertainties, one constant remains; the patient and their experiences. We should, wherever possible, involve them in the decision-making process particularly where the evidence is lacking. By appreciating the values and concerns of our patients, we shall be able to plan care that most meets their needs.

Keywords: Cancer associated thrombosis; DOACs; hospice; low molecular weight heparin; palliative; venous thromboembolism.