Venous Thromboembolic Disease

Venous thromboembolism (VTE) is a common, life-threatening condition in patients with cancer, which includes both deep venous thrombosis (DVT) and pulmonary embolism. The occurrence of VTE has been reported to increase the likelihood of death for cancer patients by 2- to 8-fold. Pathophysiologic explanations for VTE in cancer include known hypercoagulability, vessel wall damage, and vessel stasis from direct compression, and the incidence of VTE in cancer is increased by additional risks factors. The NCCN guidelines specifically outline strategies to prevent and treat VTE in adult cancer patients. These guidelines are characterized by evaluations of the therapeutic advantages of pharmacologic anticoagulation measures based on both perceived risk for bleeding (i.e., contraindications to anticoagulation) and cancer status. Important updates for 2008 include new work-up recommendations and changes in the recommendations for outpatient prophylaxis and diagnosis and for treatment of heparin-induced thrombocytopenia.

For the most recent version of the guidelines, please visit

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The Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis is committed to accelerating the fight against cancer through advances in prevention, detection, treatment, and research.

Siteman offers more than 350 Washington University physicians and investigators who treat over 7,000 newly diagnosed patients each year and hold nearly $140 million in annual research and training grants. In addition to its main campus, Siteman has 2 network locations in the St. Louis area. Siteman physicians also collaborate with community hospitals and providers throughout the region.

In recent years, Siteman's research efforts have expanded in several areas. In collaboration with Washington University's world-renowned Genome Sequencing Center, investigators are exploring translational cancer genomics. Faculty recruitments and the creation of an Institute for Public Health at Washington University have strengthened the prevention program. Other developments include the opening of a Center for Clinical Imaging Research, unique nationally for its integration in a patient-care setting, and advances in nanotechnology for cancer detection and treatment.

Timothy Eberlein, MD (second photo on cover), has served as Siteman director since 1998. He also is chairman of the Department of Surgery at Washington University and surgeon-in-chief at Barnes-Jewish Hospital.

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