Venous thromboembolism in the cancer patient

Patients with malignancies are at increased risk of developing venous thromboembolic disease. Diagnosis and treatment of deep venous thromboembolism and pulmonary embolism in this group of patients poses some unique challenges, but generally should parallel that of patients without malignancy. Prophylaxis with low-dose warfarin should be considered in patients with indwelling central venous catheters and in some patients receiving chemotherapy for cancer. Although patients who present with idiopathic deep venous thromboembolism or pulmonary embolism may be at increased risk of developing clinically apparent malignancy, there is no data to suggest that an aggressive search for cancer in these patients is more appropriate than routine physical exam and laboratory testing.