venous thromboembolism (VTE) and prostate cancer

Last edited 05/2022 and last reviewed 06/2022

Thromboembolism in men with prostate cancer

Population-based data suggest that the risk of VTE (venous thromboembolism) is twofold to threefold higher in men with prostate cancer than among men of similar age without cancer (1):

• Van Hemelrijck et al showed that:
  • for men on endocrine therapy, risks for DVT (deep vein thrombosis) and pulmonary embolismwere increased, although this was not the case for arterial embolism
  • similar patterns were seen for men who received curative treatment and men who were on surveillance
  • increased risks for thromboembolic disease were maintained when patients were stratified by age and tumour stage

Also has been shown that prostate cancer patients are at a high risk of thromboembolism following surgical intervention (2):

• surgeries for prostate cancer including TURP, are associated with hospitalization for thromboembolism. Patients with a history of thromboembolism and patients undergoing a pelvic lymph node dissection were at highest risk
• largest risk was observed from days 14 to 28 postoperatively

A nationwide cohort study was undertaken to estimate the additional risk of venous thromboembolism (VTE) in men with prostate cancer compared with men without prostate cancer in Sweden (3):

• following 92,105 men with prostate cancer and 466,241 men without prostate cancer (comparison cohort) matched 5:1 by birth year and residential region
• showed that men with prostate cancer had a mean 50% increased risk of VTE during the 5 years following their cancer diagnosis compared with matched men free of prostate cancer

Reference:

• Van Hemelrijck M et al. Risk of thromboembolic diseases in men with prostate cancer: results from the population-based PCBaSe Sweden. Lancet Oncol 2010;11:450-8.doi:10.1016/S1470-2045(10)70038-3pmid:http://www.ncbi.nlm.nih.gov/pubmed/20395174
• Van Hemelrijck M et al.Thromboembolic events following surgery for prostate cancer. Eur Urol 2013;63:354-63.doi:10.1016/j.eururo.2012.09.041pmid:http://www.ncbi.nlm.nih.gov/pubmed/23021972
• Balabanova Y, Farahmand B, Garmo H, et al.Risk of venous thromboembolism in men with prostate cancer compared with men in the general population: a nationwide population-based cohort study in Sweden.BMJ Open 2022;12:e055485. doi: 10.1136/bmjopen-2021-055485