Deep Vein Thrombosis (DVT)

Deep vein thrombosis (DVT) is when a blood clot (thrombus) forms in one of the larger, deeper veins that run through the muscles. These large veins are usually in the lower leg, thigh, or pelvis. DVT is a common complication in patients with cancer. This side effect happens because some forms of cancer, including brain cancer, ovarian cancer, lung cancer, colon cancer, kidney cancer, pancreatic cancer, lymphoma, and leukemia, increase substances in the blood that cause the blood to clot. Some forms of cancer treatment, including cancer surgery and chemotherapy, can also increase the risk of blood clots. 

DVT is not life-threatening. It can, however, become very serious if the clot breaks free, travels through the bloodstream, and becomes lodged in the blood vessels of the lungs. This causes a blockage of blood flow, known as a pulmonary embolism. Because of this possibility, early diagnosis and treatment are very important. 

Signs and Symptoms of Deep Vein Thrombosis

Even though DVT reduces the flow of oxygenated blood throughout the body, many people experience no symptoms until the problem becomes life-threatening. When symptoms do occur, they may include:

• Pain and swelling in the affected leg (rarely in both legs)
• Red or discolored skin on the leg
• The affected leg feels warm to the touch 

Tell your doctor immediately if you notice any of these symptoms of deep vein thrombosis.

Diagnosing Deep Vein Thrombosis

To diagnose DVT, your doctor will ask you about your symptoms and will perform a physical exam to check for areas of swelling, tenderness, or changes in skin color. They will recommend specific tests based on whether you are at low or high risk for blood clots.

Tests used to diagnose or rule out a blood clot include:

• D-dimer blood test. D-dimer is a protein fragment (small piece) made when a blood clot dissolves in your body. Almost all people with severe deep vein thrombosis have increased blood levels of D-dimer.
• Duplex ultrasound. This is the most common test used to diagnose DVT. It involves using high-frequency sound waves to look at the speed of blood flow to see if clots are present. Sometimes, the ultrasound technician will need to do a series of scans over several days to determine whether a blood clot is growing or to check for a new one.
• Magnetic resonance imaging (MRI) scan. This test may be done to diagnose DVT in the veins of the abdomen.
• Venography. This test uses X-rays to show your deep veins. A dye is injected into a large vein in your foot or ankle so veins and any blood clots can be seen more clearly. The test is invasive, so it is rarely performed.

Treatment Options for Deep Vein Thrombosis

The main goals of DVT treatment are to prevent the clot from growing, prevent a blood clot from traveling to the lungs, and reduce the chance of another blood clot forming. A hematologist might recommend one or a combination of the following to treat deep vein thrombosis or blood clots:

• Anticoagulants. More commonly referred to as blood thinners, anticoagulants reduce the blood’s ability to clot. While they do not break up existing blood clots, they can prevent clots from becoming larger and reduce the risk of other clots developing. Blood thinners can be taken orally, given by IV, or as an injection under the skin.
• Thrombolytics. Also called clot busters, these drugs are used to break up clots. These drugs are given by IV or through a tube (catheter) placed directly into the clot. Clot busters can cause serious bleeding; therefore, they are only used for people with severe blood clots.
• Filters. If you are unable to take medication to thin your blood, you might have a filter placed in the inferior vena cava, a large vein in the middle of your body. A vena cava filter prevents clots from moving up into the lungs. 
• Compression stockings. These knee socks are specialized to reduce the chances your blood will pool and clot. They are tight at the ankle and loosen as they go up the leg, causing a gentle pressure (compression) which prevents swelling associated with DVT. 

DVT Treatment Available in Hampton Roads-Tidewater

Be sure to speak with your Virginia Oncology Associates cancer care team about any questions or concerns you have regarding deep vein thrombosis. Together, with a VOA hematologist, we can find the best ways to manage and treat your blood clots. We have locations throughout Hampton Roads-Tidewater, including Chesapeake, Elizabeth City, Newport News, Norfolk, Suffolk (Harbour View/Obici), Virginia Beach, and Williamsburg.