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SAONS Meeting
October 27, 2010. 1800-2000.
Topic: “Treatment of Venous Thromboembolism in Cancer Patient”
Our work is caring for cancer patients everyday we come to work. This topic will
enhance our understanding why our cancer patients suffer or die from venous
thromboembolism (VTE); and how it happens. It will also help us to be aware of
sign and symptoms of VTE in cancer patients receiving chemotherapy via central
venous access devices. All of these factors further increase the risks of VTE in our
patients. Do plan to attend! It will be an interesting topic and we can bring the
information right to the bedside practice!
Our speaker is a Pharm. D. and she will discuss the epidemiology, pathophysiology
and treatments of VTE.
I would like to review with you few items about VTE that will entice you to want to
listen to this presentation even more!
Venous Thromboembolism (VTE):
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There are many cause of DVT i.e. prolonged immobilization, hormone use,
recent surgery, obesity etc…but one not often thought of is cancer
VTE indicates both DVT and PE
One of the paranneoplastic syndromes is hyper-coagulant state. (Cancer
cells can produce pro-coagulant material)
Red clots…. Venous clots…DVT and PE (= VTE)
White clots….Arterial clots….CVA and MI
It is estimated that of all cancer patients:
** Up to 20% will develop VTE in patients with active cancer
** Up to 6-fold increase the risk compared to patient without cancer
**50% will develop asymptomatic VTE
**At least 50% will have VTE at autopsy
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Seven cancers associated with increase of DVT: AML, Non-Hodgkin’s
Lymphoma, renal cell, ovarian, pancreatic, stomach and lung.
In cancer patients VTE is leading cause of death only after the death from
infections and cancer itself
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The risk of VTE increases with oncology patients who undergo surgery and/or
receive chemotherapy
Chemotherapy itself can increase the risk of thromboembolism disease
Cancer disease state itself + chemotherapy have a cumulative effect that
results in increase risk
Acute infection further increases the risk in cancer patients…be careful of UTI
in cancer patients
Central venous access devices can increase the risk of DVT up to 38% to 62%
of all patients. Those with left subclavian lines are at higher risk than the right
Watch out for patients with neuraxial indwelling catheters for intraspinal
analgesia
Cancer patients who survive an initial VTE have an increased risk for
recurrence of VTE compared to patients without cancer
VTE prophylaxis in cancer patients is severely underused
The well-recognized risk of VTE in established cancer may suggest the
idiopathic VTE that it may predict the presence of occult cancer. Further
more….it might be a good reason to screen for cancer in patients who have
idiopathic VTE.
Now let me introduce you to our speaker
Doneen Grimm, Pharm D’ s brief bio is below:
Dr. Grimm received her BS degree in Biology in 1997 from Richard Stockton College
in N. J., her BS in Pharmacy in 2000 from Philadelphia College of Pharmacy in PA,
and she received her Pharm. D in 2001 from the same college. Dr. Grimm has a wide
range of professional clinical experiences; currently she is the Interim Director of
Pharmacy in a Phoenix hospital, as well as Clinical Quality and Patient Safety
Manager, her previous experiences include: Clinical Infusion Pharmacist, and
Pharmacist. She belongs to several committees at St. Joseph’s HMC: Pharmacy
and Therapeutic, Tumor Board: Breast Urology, Pediatric and Urology, Pain Care,
Anticoagulation Committee among others. Her most recent achievement is that she
leads and organizes the Anticoagulation Team at St. Joseph’s Hospital in the
implementation of policies, procedures and practice.
See you at the meeting!
Piya Shult
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Our meeting is scheduled for Wednesday, October 27, 2010 at 1800-2000 at
Anthony’s by the foothill: 6440 N. Campbell Ave. Tucson. Phone: 299-1771.
RSVP to Kim Faber, SAONS Membership Chair: [email protected]
Cathy Parsons, SAONS Program Director
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