‘Spot the CLOT’: What cancer patients want to know

Julia A. Bayadinova, Laurie A. Sardo, Vanessa Higgins-Nogareda, Jill Scott, Brooke MacKinnon


This article is the second in a dedicated series, entitled ‘Spot the CLOT’, designed to raise awareness of cancer-associated thrombosis (CAT), with the goal of improving patient education and patient outcomes. The initial article, ‘The Signi!cance of VTE in Cancer: Introduction of the Spot the CLOT Series’, provided an overview of CAT and identi!ed knowledge de!cits in the cancer patient population (Sardo, Bayadinova, Jenkins, & Penton, 2021). It highlighted the fact that cancer patients received little to no information on the associated risk of venous thromboembolism (VTE). Strategies oered in this article are designed to raise awareness of VTE among cancer patients, oer approaches to assist with patient education on VTE and, ultimately, reduce the burden of CAT.

Full Text:



Abdol Razak, N.B., Jones, G., Bhandari, M., Berndt, M.C., & Metharom, P. (2018). Cancer-associated thrombosis: An overview of mechanisms, risk factors, and treatment. Cancers, 10: 380. http://dx.doi.org/10.3390/cancers10100380

Amalraj, S., Starkweather, C., Nguyen, C. & Naeim, A. (2009). Health literacy, communication, and treatment decision-making in older cancer patients. Oncology, 23(4), 369-375.

Berkman, N.D., Davis, T.C. & McCormack, L. (2010). Health literacy: What is it? Journal of Health Communication, 15(2), 9-19. http://dx.doi.org/10.1080/10810730.2010.499985

Berkman, N.D., Sheridan, S.L., Donahue, K.E., Halpern, D.J., Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97-107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005

Blom, J. W., Doggen, C. J., Osanto, S., & Rosendaal, F. R. (2005). Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA, 293(6), 715–722. https://doi.org/10.1001/jama.293.6.715

Chapuy, C. I., & Connors, J. M. (2020). Diagnosis, treatment, and prevention of cancer-associated thrombosis. In Niederhuber, J.E., Kastan, M.B., Tepper, J.E., Armitage, J.O., & Doroshow, J.H. (Eds.), Abeloff’s Clinical Oncology (pp. 523–543). Springer. https://doi-org.libaccess.lib.mcmaster.ca/10.1016/B978-0-323-47674-4.00033-5

Charalel, R. A., & Vedantham, S. (2017). Deep vein thrombosis interventions in cancer patients. Seminars in Interventional Radiology, 34(1), 50–53. https://doi.org/10.1055/s-0036-1597763

Guiliani, M., Papadakos, T., & Papadakos, J. (2020). Propelling a new era of patient education into practice-cancer care post-COVID-19. International Journal of Radiation Oncology Biology Physics, 108(2), 404-406.

Hews-Girard, J., Guelcher, C., Meldau, J., McDonald, E., & Newall, F. (2017). Principles and theory guiding development and delivery of patient education in disorders of thrombosis and hemostasis: Reviewing the current literature. Research Practice of Thrombosis & Haemostasis, 1, 162–171. https://doi.org/10.1002/rth2.12030

Khornana, A. A., Francis, C. W., Culakova, E., Kuderer, N., & Lyman, H. (2007). Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients. Cancer, 110(10), 2339-2346. https://doi.org/10.1002/cncr.23062

Leshkovska, E. A., & Spaseva, S. M. (2016). John Dewey’s educational theory and educational implications of Howard Gardner’s Multiple Intelligences Theory. International Journal of Cognitive Research in Science, Engineering and Education, 4(2), 57-66. http://dx.doi.org/10.5937/IJCRSEE1602057A

Lyman, G. H., Carrier, M., Ay, C., Di Nisio, M., Hicks, L. K., Khorana, A. A., Leavitt, A. D., Lee, A. Y. Y., Macbeth, F., Morgan, R. L., Noble, S., Sexton, E. A., Stenehjem, D., Wiercioch, W., Kahale, L. A., & Alonso-Coello, P. (2021). American Society of Hematology 2021 guidelines for management of venous thromboembolism: Prevention and treatment in patients with cancer. Blood Advances, 5(4), 927–974. https://doi.org/10.1182/bloodadvances.2020003442

Matsuyama, R. K., Kuhn L. A., Molisani, A., & Wilson-Genderson, M.C. (2013). Cancer patients’ information needs the first nine months after diagnosis. Patient Education Counselling, 90(1), 96–102. http://dx.doi.org/10.1016/j.pec.2012.09.009. Epub 2012 Oct 9. PMID: 23058682.

Mukai, M., & Oka, T. (2018). Mechanism and management of cancer-associated thrombosis. Journal of Cardiology, 72(2), 89-93. https://doi.org/10.1016/j.jjcc.2018.02.011

Noble, S., Nelson, A., Scott, J., Berger, A., Schmidt, K., Swarnkar, P., & Lee, A. (2019). Patient experience of living with cancer-associated thrombosis in Canada (PELICANADA). Research and Practice in Thrombosis and Haemostasis, 4(1), 154-160. http://dx.doi.org/10.1002/rth2.12274.

Noble, S., Prout, H., & Nelson, A. (2015). Patients’ experience of living with cancer associated thrombosis: The PELICAN study. Patient Preference and Adherence, 9, 337-345. http://dx.doi.org/10.2147/PPA.S79373

Poh, C., Brunson, A., Mahajan, A., Keegan, T., & Wun, T. (2019). Upper extremity deep venous thrombosis in 10 common malignancies: Analysis of incidence, risk factors, and effect on mortality from the California Cancer Registry. Journal of Clinical Oncology, 37(15 Suppl), e18190. http://dx.doi.org/10.1200/JCO.2019.37.15_suppl.e18190

Rajasekhar A., & Streiff, M. B. (2019). Etiology and management of upper-extremity catheter-related thrombosis in cancer patients. In: Soff G. (eds), Thrombosis and hemostasis in cancer (pp. 117-137). Springer. https://doi.org/10.1007/978-3-030-20315-3_8

Ramzi, D. W., & Leeper, K. V. (2004). DVT and pulmonary embolism: Part I. Diagnosis. American Family Physician, 69(12), 2829–2836.

Sardo, L. A., Bayadinova, J. A., Jenkins, S., & Penton, L. (2021). The significance of VTE in cancer: Introduction of the’Spot the Clot’ series. Canadian Oncology Nursing Journal, 31(4), 500-503.

Streiff, M. B., Ali Abutalib, S., Farge, D., Murphy, M., Connors, J. M., & Piazza, G. (2021). Update on guidelines for the management of cancer-associated thrombosis. The Oncologist, 26(1), e24-e40. https://doi-org.libaccess.lib.mcmaster.ca/10.1002/onco.13596

The Joint Commission. (2010). Advancing effective communication, cultural competence, and patient- and family-centered care: A roadmap for hospitals. The Joint Commission.

Thrombosis Canada (2021). Patient & family information. https://thrombosiscanada.ca/resourcepage/patient-family-information/

Truccolo, I., Mis, C., Cervo, S., Maso, L., Bongiovanni, M., Bearz, A., Sartor, I., Baldo, P., Ferrarin, E., Fratino L., Mascarin, M., Roncadin, M., Annunziata, M., Muzzatti, B., & Paoli, P. (2015). Patient-centered cancer care programs in Italy: Benchmarking global patient education initiatives. Journal of Cancer Education, 31, 405-412.

US Department of Education. (2006). The health literacy of America’s adults: Results from the 2003 national assessment of adult literacy. https://nces.ed.gov/pubs2006/2006483.pdf

Verso, M., & Agnelli, G. (2016). Venous thromboembolism associated with long-term use of central venous catheters in cancer patients. Journal of Clinical Oncology, 21(19), 3665-3675. http://dx.doi.org/10.1200/JCO.2003.08.008


  • There are currently no refbacks.