I recently saw a patient from Poole in Dorset who came to see me after a deep vein thrombosis
wondering whether he needed any tests. Well he was in his 60s so I had some
unpalatable news for him -- as his deep vein thrombosis was unprovoked he should have tests
to check that he does not have cancer. So what exactly do I mean by "unprovoked"? Well
this is a deep vein thrombosis that comes apparently out of the blue. That means that
in the preceding 3 months before the development of the deep vein thrombosis there has been
no evidence of major surgery major trauma there has been no immobility so the person
has not been bedridden or has spent a significant part of the day either in bed or in a chair
the person is not pregnant and the person is not taking hormone replacement therapy
or the oral contraceptive pill. Now if a deep vein thrombosis is unprovoked and the person
is under 40 then they should have as a bare minimum a full examination a chest x-ray some
screening blood tests and their urine should be analysed. Now if the person is over the
age of 40 and has an unprovoked deep vein thrombosis then they should be fully investigated
for cancer. And that means a mammogram in a woman and in both men and women a CT scan
of the abdomen and pelvis. Now I don't want to cause alarm but approximately 10% of people
who have an unprovoked deep-vein thrombosis then find that they
have a cancer within the next 12 months. Now they probably had the cancer it's only just
become apparent with time. And we know if you diagnose cancer early you get better results.
So screening people with an unprovoked deep vein thrombosis gives a really good opportunity
to diagnose a cancer at an early stage when it might well be treatable and perhaps be
life-saving. So please do not be alarmed but if you have had a deep vein thrombosis which
has apparently come out of the blue you ought to see your doctor. If you are over the age
of 40 I think now it is probably best that you are referred to a haematologist in a hospital.
He is a specialist who can assess your risks and perform the appropriate investigations.
Now I am going to put a link in the box below to the NICE guidance on this matter which
came out a year ago and I hope you find it useful. Now I hope you have enjoyed watching
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