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Health Protocols

Cancer Treatment: The Critical Factors

Step Six: Correcting Coagulation Abnormalities

Both experimental and clinical data have determined that coagulation disorders are common in patients with cancer. Many cancer patients reportedly have a hypercoagulable state, with recurrent thrombosis (blood clot) due to the impact of cancer cells and chemotherapy on the coagulation cascade.83 Pulmonary embolism (blood clot in the lung) is a particular problem for patients with pancreatic and gastric cancer, colon cancer, and ovarian cancer.84 Thus, momentum is building for anticoagulant therapy through reports, the vast majority of which are derived from secondary analyses of clinical trials on the treatment of thromboembolism.

Research on low-molecular-weight heparin (LMWH)—an anticoagulant—shows promise in regard to increasing cancer survival rates. Data comparing unfractionated heparin to LMWH indicate that LMWH is equally beneficial if not more beneficial to cancer patients in terms of survival. The improved life expectancy gathered from anticoagulant therapy is not solely a result of the reduced complications from thromboembolism, but also from enzyme interactions, cellular growth modifications, and anti-angiogenic factors.85,86 It appears heparin inhibits the formation of cancer's vascular network by binding to angiogenic promoters (ie, basic fibroblast growth factor and VEGF).87

Another important aspect of anticoagulant therapy involves breaking down fibrin, a coagulation protein found in blood. Cancers employ various strategies to utilize fibrin for their own benefit. For example, fibrin covers cancer cells with a protective coat, hindering recognition by the immune system. In addition, fibrin relays a signal to the cancer to initiate angiogenesis—the growth of new blood vessels. As fibrin encourages a healthy vascular network and tumor growth increases, it sets the stage for metastasis.

German scientists evaluated whether cancer fatalities in women with previously untreated breast cancer were reduced using LMWH therapy. The study showed that breast cancer patients receiving LMWH had a lower rate of mortality during the first 650 days following surgery, compared to women receiving unfractionated heparin. The survival advantage was apparent after even a short course of therapy.88 In another study of 300 breast cancer patients, none of the trial participants developed metastasis while receiving anticoagulant therapy although 37 (12.3%) died from the disease.89

Similar advantages were evidenced among small cell lung cancer patients undergoing heparin therapy in conjunction with conventional treatments. When subjects were treated with heparin they enjoyed a better prognosis, with greater numbers of complete responses, longer median survival, and higher survival rates at 1, 2, and 3 years compared to patients who did not receive heparin.90

A comprehensive analysis of the data pertaining to all studies published on the impact of heparin treatment on survival in cancer patients determined that treatment with heparin (both unfractionated heparin and LMWH) decreased the risk of death by 23%, compared to those who did not receive heparin.91

How to Implement Step Six

Ascertain if you are in a hypercoagulable state by having your blood tested for prothrombin time (PT), partial thromboplastin time (PTT), and D-dimers. A hypercoagulable state is suggested if the shortening of the PT and PTT are seen in conjunction with elevation of D-dimers (see table after next paragraph on laboratory tests for hypercoagulability).

If there is any evidence of a hypercoagulable (prethrombotic) state, ask your physician to prescribe the appropriate individualized dose of low-molecular-weight heparin (LMWH). Repeat the prothrombin blood test every two weeks.

Lab Tests for Hypercoagulability

Tests Routinely Available

Results if Hypercoagulable

Tests Requiring Dedicated Coagulation Laboratory

Results if Hypercoagulable

Prothrombin time (PT)

Less than normal

Alpha-1 antitrypsin (A1AT)

Elevated

Partial thromboplastin time (PTT)

Less than normal

Euglobulin clot lysis time (ECLT)

Prolonged

Platelet count (part of CBC)

Elevated

Factor VIII levels

Elevated

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