Anticoagulant treatment of cancer associated venous thrombosis

Venous thromboembolism is a shadow over the malignant diseases. Many patients experienced venous thrombosis or pulmonary embolism during the course of malignant disease and those complications may precede overt malignant disease for months. The association between malignant disease and venous thrombosis represent malignant potential of disease and usually mean dismal prognosis. Different cancers have different propensity to cause thrombosis and pancreatic, stomach and brain tumors yield the highest risk, however, colonic, lung, prostate and breast cancers are more prevalent and the number of vein thrombosis is predominant in association with these tumors. In the last two years, a strong medical evidence become available from the randomized trials and now, direct oral anticoagulant drugs (rivaroxaban, edoxaban and apixaban) become equally recommended to patients with venous thrombosis as low molecular weight heparins which were the standard therapy. For rivaroxaban and edoxaban, higher prevalence of major bleeding was associated to gastrointestinal carcinomas.