Integrative Oncology Essentials
One of the the facts I emphasize during my integrative oncology talks is that the majority of patients with cancer do not die from their cancer, but instead from a side effect or complication related to their cancer or the cancer treatment.
- FACT: One in five cancer patients will develop a potentially life threatening blood clot within their first year of their diagnosis (and up to 50% by the time of death.)
This blood clot is called a DVT (deep vein thrombosis.) Typically, they develop in the veins of the arm, leg or pelvis, and they can present with swelling, pain, redness, warmth, or heaviness in the affected area.
If they dislodge and travel to the lung, heart or brain, they can become deadly. A VTE (venous thromboembolism) is the term used for any DVT that ends up in another part of the body.
- The most well known VTE is a PE (pulmonary embolism), a DVT that gets stuck in the veins of the lung and blocks critical blood flow to lung. This can present with shortness of breath, cough or chest pain. Without rapid diagnosis and treatment it can be fatal.
The increased risk of blood clots and cancer is not recent news…it’s been known since 1865!
It’s hard for me to imagine, but one study reported that more than one-quarter of oncologists believe cancer patients are not at increased risk for blood clots.
WHO IS AT GREATEST RISK OF DEVELOPING A BLOOD CLOT?
DVT’s occur much more commonly among those with certain risk factors:
- Having Cancer (some cancers are more associated with blood clots)
- Recent major surgery or trauma
- Having a central venous catheter
- Receiving drugs that increase the risk of blood clots (i.e. hormonal therapy, numerous chemotherapy drugs, white and red blood cell growth factors)Being obese or overweight
- Physical inactivity (read about Physical Activity and Cancer on our prior blog post)History of a prior stroke (or transient ischemic attack, TIA)
- prolonged hospitalization or bedrest are notorious risk factors…but even short periods (i.e. a few hours) of inactivity can increase your risk
- History of a heart attack or coronary artery disease (read about Cardiac Complications After Cancer on our prior blog post)
- History of a prior blood clot (or family history of blood clots)
- High blood pressure
- Smoking
- Having atrial fibrillation (and abnormal heart rhythm)
- High LDL and total cholesterol levels and/or low HDL levels (known risk factors for the development of atherosclerosis: clots often form in areas of arterial plaques on blood vessel walls)
- Having a low red blood cell count (anemia), having a high platelet count or having a high white blood cell count
- Elevated levels of homocysteine or high-sensitivity C-reactive protein (hsCRP)
- High blood sugar levels
- Drinking more than 1 serving of alcohol per day
- …and a variety of other conditions (i.e. thyroid abnormalities, pregnancy, high blood fibrinogen levels)
Deep vein thrombosis (DVT) in the leg on the left.
- Risk factor assessment model (for those with a diagnosis of cancer)
- PreventDVT.org risk calculator (for those with or without a diagnosis of cancer)
HOW DOES CANCER INCREASE THE RISK OF BLOOD CLOTS?
- Cancer cells produce blood clotting and inflammatory proteins that make the blood more likely to clot.
- Numerous medications used to treat cancer can increase the risk of blood clots.
- As a result of cancer or cancer treatment, many patients get out of shape, or have pain or limitations in their range of motion. This can lead to physical inactivity, increased obesity and systemic inflammation…all known risk factors for developing blood clots.
- A recent surgery or hospitalization is the most common risk factor for developing DVT’s (typically as a consequence of prolonged inactivity leading to pooling of blood in the legs and pelvis.
- When your legs remain still for long periods, your calf muscles don’t contract, which normally helps blood circulate. Blood clots can form in the calves of your legs if your calf muscles aren’t moving.
HERE ARE MY RECOMMENDATIONS TO HELP REDUCE THE RISK OF BLOOD CLOTS:
- Increase physical activity:Maintain a healthy weight
- Exercise your legs frequently while you’re sitting
- Exercise regularly (goal: at least 30 minutes of moderate aerobic exercise, 5-days per week)
- Get up and walk around every 2 to 3 hours
- Stop smoking! (and avoid second-hand exposure)
- Reduce stress (read how stress increases inflammation on our prior blog post)
- Limit alcohol consumption to 1 serving per day (preferably red wine)
- Consume an anti-cancer/anti-inflammatory diet
- Consider taking a daily, low-dose (“baby aspirin”):
- Recent studies have reported that individuals who take a low-dose aspirin every day may reduce their risk of blood clots by 40%.
- Read our prior blog post on how taking “One Baby Aspirin Per Day Cuts Cancer Development, Metastases and Death!“
- The active ingredient in aspirin is a plant-derived compound called a “salicylate.” Instead of taking a baby aspirin, you could simply consume foods that have high salicylate content (as well as many anti-cancer and anti-inflammatory phytonutrients):
- Fruits: apricots, oranges, blackberries, pineapple, blackcurrant, plums, blueberries, prunes, raspberries, strawberries, grapes, cranberries, tangerines, tomatoes
- Spices, herbs and others: curry, cayenne, paprika, thyme, turmeric, ginger, dandelion, gingko, licorice and peppermint, wine, vinegar, honey, cider
Consume foods that are rich in vitamin E or omega-3 fatty acids (both of which have blood thinning properties and may reduce the risk of blood clots):
- Sources of omega-3 fatty acids include:
- Fatty fish (i.e. anchovies, salmon, lake trout, herring, mackerel) and fish oil
- Plant sources (i.e. flaxseed, sunflower seeds, canola oil, corn oil, safflower oil, soy)
- Vitamin E rich foods include:
- Nuts (i.e. walnuts, almonds, hazelnuts)
- Vegetable oils (i.e. canola oil, sunflower oil, palm oil)
- Lentils (i.e. chickpeas)
- Oats and wheat
- Sources of omega-3 fatty acids include:
Other foods and supplements that reduce blood clotting:
- Curcumin
- Polyphenol-rich foods
- Vitamin C
- Nattokinase (a compound produced during soy fermentation; found only in natto, which smells like very dirt socks, so unless you can stomach that scent I suggest taking nattokinase supplements)
- Garlic
- Gingko biloba