How Does Cancer Cause Blood Clot Formation

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Cancer associated thrombosis: how does cancer cause blood clot formation and how we treat it?
Introduction
Thrombosis is a major complication of cancer, and was first described by Trousseau in 18651. Due to its close association with cancer, spontaneous venous thromboembolism (VTE) always triggers investigations to exclude any occult malignant disease. VTE is the second highest cause of death in cancer patients2. It can present as superficial thrombophlebitis, pulmonary embolism, deep venous thrombosis, arterial thrombosis, thrombotic endocarditis and clotting of central venous catheters in these patients3.
There are many causes of thrombosis in cancer that can be cancer-related, patient-related and treatment-related. The molecular and cellular …show more content…
This interaction also induces the direct activation of factor VII. The interaction between tumour cells and macrophages also activates platelets, factor XII and factor X leading to the generation of thrombin and thrombosis.
Procoagulant substances in tumour cells like tissue factor (TF) and cysteine protease can directly activate factor X in the coagulation cascade which results in thrombus formation5. Cancer induced inflammation increases acute-phase proteins like fibrinogen, von Willebrand factor and coagulation factor VIII which also promote thrombosis6.
Studies have shown a significant upregulation of TF in malignant cells7. The cysteine protease plays a role in the prethrombiotic stage in certain malignant diseases by activation of factor X. This activity is distinct from factor IXa, factor VIIa and TF. TF initiates blood coagulation, leading to the generation of thrombin. Thrombin then further increases the growth and metastatic ability of the tumour. TF also plays an important role in tumour related angiogenesis. Cancer induced inflammation increases acute-phase proteins like fibrinogen, von Willebrand factor and coagulation factor VIII which also promote
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