Cancer Treatment Today

Thrombophelbitis in a cancer patient does not respond to coumadin and he needs conintuous treatment with low molecular weight heparin, such as lovenox. The dose is appropriate for treatment.
Cancer patients require frequent interruption of anticoagulation for procedures, which further compounds the difficulty of warfarin dose management. In one large randomized trial, the INR was within the target range in the warfarin group only 46% of the time. Even when the INR is within the target range, however, VTE can still occur.

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2. Carrier M, Khorana AA, Zwicker J, et al. Management of challenging cases of patients with cancer-associated thrombosis including recurrent thrombosis and bleeding: guidance from the SSC of the ISTH. J Thromb Haemost 2013; 11:1760.
3. O’Connell CL, Boswell WD, Duddalwar V, et al. Unsuspected pulmonary emboli in cancer patients: clinical correlates and relevance. J Clin Oncol 2006; 24:4928.