Cancer & Coagulation

New Swedish/German/US study [1] below.

The full text isn't free ($35.95), & the Abstract has limited value in terms of how we can use the info - but the intro has shock value & might cause some to consider D-dimer /fibrinogen blood tests & nattokinase as a supplement (see my earlier post.)

"Cancer is an established risk factor for venous thromboembolism (VTE) and VTE is the second leading cause of death in patients with cancer. The incidence of cancer-related thrombosis is rising and is associated with worse outcomes."

"Despite our growing understanding on tumor-driven procoagulant mechanisms including cancer-released procoagulant proteases, expression of tissue factor on cancer cells and derived microvesicles, as well as alterations in the extracellular matrix of the cancer cell milieu, anticoagulation therapy in cancer patients has remained challenging."

Doctors have no tools, so they keep quiet about the problem.

The published statistics on PCa underestimate PCa deaths. PCa-related clotting events, etc. are not included. If we are not careful, we might avoid a "PCa death" without extending survival.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/272...

US National Library of Medicine National Institutes of Health

The polyphosphate/factor XII pathway in cancer-associated thrombosis: novel perspectives for safe anticoagulation in patients with malignancies.

Nickel KF1, Labberton L2, Long AT3, Langer F4, Fuchs TA3, Stavrou EX5, Butler LM1, Renné T6.

Author information

1Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Clinical Chemistry, Department of Molecular Medicine and Surgery, Karolinska Institutet and University Hospital, Stockholm, Sweden.

2Clinical Chemistry, Department of Molecular Medicine and Surgery, Karolinska Institutet and University Hospital, Stockholm, Sweden.

3Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

4Clinical Department of Hematology and Oncology, Center for Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

5Divisions of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA; Department of Medicine, Louis Stokes Veterans Administration Hospital, Cleveland, OH, USA.

6Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Clinical Chemistry, Department of Molecular Medicine and Surgery, Karolinska Institutet and University Hospital, Stockholm, Sweden. Electronic address: thomas@renne.net.

Abstract

Cancer is an established risk factor for venous thromboembolism (VTE) and VTE is the second leading cause of death in patients with cancer. The incidence of cancer-related thrombosis is rising and is associated with worse outcomes. Despite our growing understanding on tumor-driven procoagulant mechanisms including cancer-released procoagulant proteases, expression of tissue factor on cancer cells and derived microvesicles, as well as alterations in the extracellular matrix of the cancer cell milieu, anticoagulation therapy in cancer patients has remained challenging. This review comments on a newly discovered cancer-associated procoagulant pathway. Experimental VTE models in mice and studies on patient cancer material revealed that prostate cancer cells and associated exosomes display the inorganic polymer polyphosphate on their plasma membrane. Polyphosphate activates blood coagulation factor XII and initiates thrombus formation via the intrinsic pathway of coagulation. Pharmacologic inhibition of factor XII activity protects mice from VTE and reduces thrombin coagulant activity in plasma of prostate cancer patients. Factor XII inhibitors provide thrombo-protection without impairing hemostatic mechanisms and thus, unlike currently used anticoagulants, do not increase bleeding risk. Interference with the polyphosphate/factor XII pathway may provide the novel opportunity for safe anticoagulation therapy in patients with malignancies.

Copyright © 2016 Elsevier Ltd. All rights reserved.

KEYWORDS:

anticoagulation; cancer; contact system; factor XII; polyphosphate; pulmonary embolism

PMID:

27207422

[PubMed - as supplied by publisher]

2 Replies

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  • Patrick, I can't thank you enough for all the work you do to make us aware of research findings & what they suggest for us. I don't know if this is possible, but if you can bring your posts even more into the language of non-scientists, I for one would find them even more valuable. (Also, I was confused by your last paragraph & wondered if it really says what you meant.)

    I've read your previous post on coagulation, also. I'm on many meds & an absurd # of supplements, so I'm hoping to discover if there's any way to say I don't need this one. Based on your analysis of the literature, does VTE become a greater danger the longer one lives with advanced PCa, or do those at risk of VTE dying without extended survival times? Is VTE risk a function of what treatments a patient has been on & for how long? Are there other factors that increase or decrease risk? Or should we all be on NK, & maybe I should be thinking of dropping some other supplement if I need the cabinet space?

    Thank you very much!

    Neal

  • Hi Neal,

    I shall strive to do better. Some topics are more approachable than others. "Coagulation" is warm & fuzzy compared to the "PI3K/Akt/mTOR signaling pathway".

    As to my final sentence, some studies have found that being treated for PCa does not improve overall survival. Very little attention is paid to comorbidities, including those caused by PCa treatment. It's a shame, because certain events are avoidable.

    What are the the main clotting risks for men?

    1] Age, in that testosterone steadily falls & estradiol tends to rise. Excess estrogen is a coagulation risk factor.

    lifeextension.com/magazine/...

    2] Cancer:

    ncbi.nlm.nih.gov/pubmed/232...

    3] Inflammation:

    ncbi.nlm.nih.gov/pubmed/200...

    4] ADT (as previously discussed)

    -Patrick

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