Advanced Prostate Cancer
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Chemotherapy and air travel and risk of clots

I have been advised about the risk of clots forming during air travel and in particular while undergoing chemotherapy (I have completed 5 of 6 infusions of docetaxel). There is as ever lots on the internet (this is a good article: sci.utah.edu/~macleod/trave... However, just wondering if anyone has any practical experience of this risk? I plan to do an 8-hour flight overseas next week.

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Can you take a baby aspirin? Also Neosporin in the nose is a good way to catch the bacteria floating around before it enters body.

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I plan to give myself a Clexane injection before flying ("Clexane injection contains the active ingredient enoxaparin, which is a type of medicine called a low molecular weight heparin. It is used to stop blood clots forming within the blood vessels."). I will also carry a basic surgical mask though haven't used one in any context so far.

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I have currently had 9 ChemoTherapy treatments. About a month ago I ended up in the hospital with pulmonary embolism because of blood clots in my lungs. I found out at that time that the risk is much higher of developing blood clots while getting ChemoTherapy. I'm now doing oxygen therapy 24X7 waiting for my lungs to heal and taking the blood thinner Eliquis for the rest of my life.

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If you don't mind me asking, have the clots been brought on my extraordinary circumstances (like air travel) or through the natural course of events? Did you have any physical symptoms prior to the pulmonary embolism? For example, difficulty in breathing, swelling in the legs, etc?

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There were no extraordinary events such as air travel. I had absolutely no physical symptoms prior to the pulmonary embolism. When it happened, I got a sharp pain in my left breast which did not go away. We had planned a trip which would have happened after the hospital stay. Since I am on oxygen now, we've delayed that trip until my lungs have healed.

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I have a number of posts on altered coagulation in PCa. Having experienced a double DVT & 3 months of Warfarin (6 years ago), I will describe what I now do.

The clotting cascade starts with the aggregation of platelets, followed by the acretion of fibrin. Some take low-dose aspirin to inhibit the clumping of platelets, but I prefer nattokinase to dissolve unwanted fibrin.

If you were to present at the ER with chest pains, they would do a D-dimer test. If zero, that would rule out a clot.

Circulating plasmin is the enzyme that breaks down fibrin. D-dimer is a breakdown particle. With abnormal coagulation, plasmin cannot keep up with clot growth - it works (necessarily) slowly. Nattokinase has a similar structure to plasmin but works faster.

While D-dimer can be elevated for other reasons, men with PCa, & no other conditions, should assume that a clot is the culprit. High doses of nattokinase will quickly deal with the problem, although D-dimer will initially rise. Ultimately, D-dimer will get very close to zero.

For a long flight, you might want to consider compression stockings:

en.wikipedia.org/wiki/Compr...

-Patrick

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Use anti embolic stockings, hydrate before and during the flight and move around as much as you can during your flight, perhaps an isle seat during flight. Last November we made a trip to Hawiii against Urologist and Oncologist's advice, we broke up the flight for my husband , 5 and 4 hours, don't know if that is a possibility or if your destination allows only straight flights? Whatever you do have a safe flight and best wishes.

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Good Wednesday Morning Ian2017,

I developed both DVT and multiple PEs (but no symptoms of either) in 2013. Occurred after extremely long flights to and from Africa, I had been prescribed Vivelle dot estrogen patches by Dr. Snuffy Myers, and I have Stage 4 PCa.

A set of routine scans for PCa probably saved my life.

Since then I have taken both warfarin and Lovenox off and on and have had 2 recurrences of milder DVTs, once as a drug side effect (Revlimid in particular).

Best wishes. Never Give In.

Mark, Atlanta

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Thanks for your very interesting insights. Have you flown long distance again since developing DVT/ PEs? Where did they pick it up on the scans?

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Hi Ian,

We have traveled internationally since then and I have either been on warfarin or Lovenox and always wear prescription compression socks.

Dr. Myers used to send his patients to Sand Lake Imaging in Orlando annually for 3 days of imaging: CT, Feraheme MRI (no longer available) and bone PET/CT scan. My DVT and PEs were picked up on both the CT and MRI. I was very lucky because the radiologist (who owned and operated Sand Lake) took his time doing detailed write ups and I did not know that I had this life threatening condition for almost 1 month!

Mark

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Correction: The PEs were picked up on scans, but DVT found by ultrasound when in hospital.

Mark

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i see a hematologist/oncologist for an unrelated disorder called antiphospholipidosis...an acquired immune disorder that causes my blood clot. i take eliquis for life and asked the doc about flying. he said, and i am quoting him, he who also administers chemo to his patients for various cancers, ''just as i tell my patients on chemo, and tell those with your disorder, if the flight is more than two hours see me about heparin shots for the flight.

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I see that Clexane (prescribed for me - I inject myself about two hours before flying) is a form of heparin: "Clexane injection contains the active ingredient enoxaparin, which is a type of medicine called a low molecular weight heparin. It stops blood clots forming inside the blood vessels." netdoctor.co.uk/medicines/h...

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same diff.

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Make sure you walk around during flight; especially long flights. I once had a disagreement with a Flight Attendent who wanted me to sit down. I explained that I am concerned about DVT during a medical condition. She didn't care. I politely told her to get her supervisor and all was cool. They really did not want me to die in flight.....

GD

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