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S
OPHIYA HAQUE was about
to star in a new West End
show last December when,
on the eve of opening night,
she was struck by terrible
back pain.
Why are so
many cancer
patients
needlessly
dying from
blood clots?
Most people would have gone to the ­doctor.
But the 41-year-old actress, singer and
dancer, best known for her stint as Poppy
Morales in Coronation Street, just took
­painkillers instead.
‘Dancers accept pain is part of life,’ says her
partner David White, a musical ­director and
West End show veteran. ‘I was desperately
worried, but Sophiya had that show-mustgo-on mentality.’
A month later, in the early hours of January
17, Sophiya died in hospital, having been
diagnosed with ­cancer — probably ovarian
— that spread to her back, bones and lungs.
But her death was so sudden that doctors
are convinced it was caused by a blood clot
on her lung, called a ­pulmonary embolism.
Doctors are increasingly realising that
many cancer patients do not die from the
cancer itself but from clots that may have
been preventable.
Shocking figures from the charity Lifeblood
show that for every seven cancer patients
who die in hospital, one will succumb not to
the disease itself, but to pulmonary
­embolism, one of the main causes of death
linked to blood clots.
Campaigners are now calling for better
awareness among medics and patients.
‘If you have cancer, you’re seven times more
likely to have a blood clot. For some cancers
the risk is increased 28-fold,’ says Dr Simon
Noble, clinical reader in palliative medicine
at Cardiff University and Lifeblood’s
­authority on cancer-related blood clots.
One reason is that tumours produce molecules called cancer procoagulants that make
blood stickier, increasing the risk of clots.
The most significant procoagulant is
known as tissue factor, which amplifies
the body’s clotting ­ processes by more
than 100-fold.
‘Cancer treatment itself can also
increase the risk of blood clots,’ says Dr
Noble. ‘Chemotherapy reduces the body’s
natural defences against clots.’
Patients having surgery are generally
more vulnerable to clots as they are
­i mmobile during and after the
operation, but the risk doubles if
deteriorated and on January 10 she
for medics to intervene. But her
they have cancer. If the clot travels
went into intensive care.
partner David is haunted by the
to the lung, it can lodge in the
‘The hardest thing for me is that I
thought that more could have been
arteries and ­prevent oxygen traveldone to prolong her life.
wasn’t with her when she died,’
ling to organs around the body via
says David.
‘I don’t think these facts are
the blood.
He had been at ­Sophiya’s side for
widely known,’ he says. ‘Sophiya’s
two weeks when hospital staff
brother-in-law Steve, an anaesthetic practitioner, said early after
urged him to get some sleep. On
her arrival that she was in danger
January 16, he kissed her goodnight
arge clots stop blood
of having a clot travel up into her
and left.
pumping round the body
lung. He ­ discussed it with the
‘A couple of hours later, at
altogether, quickly causing
specialist but I think his
about 1am, Sophiya became
death. Cases of these clots,
very uncomfortable and
knowledge was superior
known as cancer-related venous
apparently got up,
to
most of those
thromboembolic disease, are rising.
­saying, “I’ve got to go
around him.’
This is partly because patients are
back. I’ve got to go
Sophiya had been
living longer and cancers are being
home.”
fit and healthy until
picked up earlier, when they are
‘She couldn’t, of
the opening night of
The
increase
in
still operable, so more patients are
course, because she
her show, Privates
undergoing surgery.
was attached to all
On Parade. She gritrisk of getting a
Ovarian, brain and pancreatic
ted her teeth
sorts of wires. As
blood
clot
­cancer have the highest rates of
staff helped her back
through two weeks
blood clots because they release
of painful performafter an hour of into bed, she died. It
more ­cancer procoagulants.
all ­happened extremely
ances before seeing
sitting down quickly.’
Lifeblood is campaigning for
her GP on January 2.
­better education within the ­medical
She was immediately
Cases of fatal blood clots
profession about the ­ connection
in patients are increasing,
referred to hospital and
between cancer and clots.
but some GPs and oncologists are
never came home. Sophiya was in
such pain that ­ several days
unaware of the risks, says Dr
‘While excellent progress has been
passed before doctors could carry
Noble, who helped develop
made to combat blood clots
­i nternational guidelines on the
out a biopsy.
acquired in hospital following surcondition. A 2003 survey found 80
When they did, it showed she had
gery, many healthcare professionals
per cent of oncologists were not takcancer. But by then the disease had
still don’t appreciate the increased
ing
any measures — such as giving
spread
and
doctors
were
unable
to
risk to cancer patients,’ says Dr
find its primary source. They ­suspect
the blood-thinning drug heparin —
Noble, an honorary consultant at
it was ovarian — a type ­ carrying a
to counter clots.
Royal Gwent Hospital in Newport.
The same number did not believe
high risk of blood clots. Her health
For Sophiya, there was little time
L
10%
all in the mind HOPE
How your emotions affect your health
This week: hope.
THE question of whether hope and a
­p ositive outlook can speed
­recovery from diseases such as
cancer is a controversial one.
Two trials at the University of
Hull on women with breast
­cancer found those given treatment such as relaxation therapy
had higher levels of immune cells
controlling the spread of cancer.
But Leslie Walker, emeritus professor of cancer rehabilitation, who led the
studies, says: ‘Some of these therapies can
produce measurable changes in immune
defences, but no one has shown that the
changes increase survival.’
In 2002, a review of 26 pieces of
research published in the British
Medical Journal found little
­evidence for a link between
hope and cancer survival, and a
German study, based on 40,000
people over ten years, found
those who overestimated their
future happiness had a 10 per cent
increased risk of death. Pessimists
were more likely to live longer.
CHLOE LAMBERT
es
By Ruth Wood
Daily Mail, Tuesday, August 6, 2013
Picture: Dan Wooller / Rex Featur
Page 40
Tragic death: Sophiya Haque
suffer fever and breathlessness. Last
year, the National Institute for
Health and Care Excellence (NICE)
published new guidelines specifying
heparin should be prescribed for at
least six months to treat existing
clots in people with cancer and to
prevent recurrence.
chemotherapy increased the risk of
blood clots.
Since then, awareness has
improved, but many hospitals still
don’t have protocols for dealing with
blood clots among chemotherapy
patients, says Dr Noble.
Even when GPs are aware of risks,
a 2012 study led by Dr Noble ­suggests
some do not give proper medication
to cancer patients who have already
had a clot.
Heparin has been shown to be
twice as effective as other anti­coagulants in cancer patients, but
the study, carried out in two areas of
the UK, found a reluctance among
many GPs to prescribe it.
One reason, says Dr Noble, may be
that heparin, unlike the oral drug
warfarin, is injected.
If patients can’t inject themselves,
a district nurse may be called, pushing up costs. Some doctors also want
to spare patients the extra distress
injections may cause.
‘In 2003 we interviewed 40 ­palliative
care patients about heparin,’ says
Dr Noble. ‘No patient reported
­distress and the overwhelming view
was that the drug was an acceptable
­intervention which patients would
opt for if given the opportunity.’
A pulmonary embolism is not
always a quick and distress-free
death. Sixty per cent of patients
take around of two hours to die and
B
ut preventing clots is
more complicated, as
there are not always
symptoms.
Those that do occur include pain,
swelling or hot or ­discoloured skin
on the legs, larger than normal
veins near the surface of the leg,
shortness of breath, pain in the
chest or upper back, and coughing
up blood.
Lord Kakkar, director of the
Thrombosis Research Institute,
says: ‘With the burden that cancer
patients have to bear, it doesn’t
seem appropriate to give bloodthinning treatment to all patients.
We need to pinpoint those at
greatest risk.’
Patients can help themselves by
staying hydrated, not smoking and
staying as active as possible.
Seven months since her death,
Sophiya’s two elder sisters, her 82year-old mother Thelma, and David
are trying to pick up the pieces. David
recently organised a memorial ­service
for fans of his partner, who was also a
Bollywood star and appeared in the
Hollywood film Wanted.
‘Sophiya was an amazingly positive
human being, loved by ­hundreds of
thousands of people. I wanted to do
something for them,’ he says.
‘She wouldn’t want me to sit
around and be a victim. It would
mean the cancer had won twice.’
n thrombosis-charity.org.uk
The foods that add up to your
recommended amount
VITAMIN MATHS daily ­
+
+
+
=
RDA of 6 mg
­ antothenic
p
acid
(­vitamin B5)
2 grilled
500 ml straw1½ small (250 g)
tomatoes
berry milkshake
avocados
(0.3 mg)
(1.5 mg)
(2.8 mg)
A MEMBER of the B complex group of these foods. The vitamin also helps in
­vitamins, pantothenic acid works with the manufacture of antibodies.
the others involved in metabolising
Other good sources of vitamin B5
­carbohydrates, proteins and fats.
include mushrooms, chicken and
It plays an important role in the Krebs potatoes.
cycle, where energy is released from
ANGELA DOWDEN
140g salmon
fillet (1.4 mg)