Coumadin and Metastases

[John603]

Hopefully some of the knowledgeable clubbers will be able to answer this question. Does taking a blood thinner like Coumadin affect whether or not metastases grow and/or develop? The reason I ask is because Avastin seems to do the opposite of Coumadin by blocking the blood supply of tumors. Now that I'm off of Avastin and on coumadin are my tumors getting an enhanced blood supply?

[missjv]

why are you on coumadin? if it is for your port ask if you can not take it. i take an asprin a day and have had no problems with port i refused the coumadin when i was told i had to have it because of port. ask your onco


missjv

[John603]

Missjv,

I had a small blood clot in my lung a couple of weeks ago. I was initially put on Lovenox shots and Coumadin. I'm now off of Lovenox but still on the Coumadin. At my infusion last week they held Avastin and the oncologist that I saw said that I was probably off of it for good due to the clot, but that my regular oncologist would make the call when I see him next week.
Prior to the blood clot I had a mixed CT Scan. Most of my metastases had shrunk, but two of them showed some growth. I'm hoping that Folfiri can hold them off.

[Hannah]

Hi John,

I have never seen any link between taking Coumadin and the growth of tumors. It may seem like it but Coumadin and Avastin aren't "opposite" drugs or anything like that - Avastin actually doesn't work on the blood itself, but on the growth of blood vessels -by "strangling" and killing off the blood vessels so that blood can't get through to the tumors. Coumadin goes to work on the blood itself, "thinning" it and making it harder to clot.

Like missjv said, it may not be necessary if you are only taking Coumadin for your port. My dad takes Coumadin because he has had a heart attack and mild stroke, and so it's absolutely vital that he take it. My mom was taking it for her port, but when we told the doc she had to cut down on the drugs (19 pills a day was tooo much to take!), that is one that he cut out.

Hannah

[justsing]

I seem to recall a study going on that was examining the potential benefit of LMWH drugs like Lovenox on prevention of recurrence. I think Gaelen might know something about it. I do not remember if there were any posted results.

I hope that there is no down side to taking Lovenox, cuz I'm on it for life! Many cancer patients have what is called hypercoagulability which means we are prone to clots. I had a large and nasty one develop after my liver resection and they put me on Lovenox for that. My onc feels that I should just stay on it since I am now a "proven clotter." It's not fun, and my belly bruises have bruises, but I'd rather not toss a clot and buy the farm!

[Terry]

Hannahw is correct in that they work totally different. Your coumadin is to keep the blood from forming clots. It's used for people that have had blood clots, heart valve replacements, heart attacks, and a few other things. Why are you taking? If it's for your port is that because your through with chemo?

[missjv]

JUST DOUBLE CHECKING CAUSE I KNOW SOMETIMES ONCS WILL PUT PEOPLE ON COUMADIN BECAUSE THEY HAVE PORTS AND THAT IS NOT NECESSARY. REGULAR PORT FLUSHES WILL KEEP THE PORT FLOWING OR SO I HAVE BEEN TOLD.

MISSJV

[Hannah]

The port flushing and the coumadin are for different things, so doing one doesn't mean you don't do the other one. The flushing is to keep the port and catheter working and not "clogged up." The coumadin is for the blood in your veins, so that it doesn't decide to stick to the catheter and give you clots in your bloodstream. Think of it like having a water hose - you don't want the inside to clog up with dirt, but you also don't want dirt caked on the outside - so you keep both areas clean, but use a different "tool" for each one when it's your port.

Hannah

[Candyys03]

Everyone is different.
I have been on warfarin (generic for coumadin) since 2006.After I had my colon surgery I developed a blood clot in my abdomen and they started me on warfarin.When I'm the hospital they always give me heparin.I always get a pic line not a port because a port is to close too my heart and difficult to put in for someone on blood thinners but I could get one if needed it.Even getting your teeth cleaned is an issue because you have to stop your blood thinner.
http://en.wikipedia.org/wiki/Peripheral ... l_catheter
Last year they put this ivc filter in my vein above my abdomen to prevent any clots from getting to my heart.
http://en.wikipedia.org/wiki/Inferior_vena_cava_filter
Before my liver surgery this year I had to have the lovenox shots for three days.I asked about switching to the shots but my doctor said that because I was doing well on the warfarin it was not necessary. On the pills it is harder to manage food for a good INR score especially if you're on chemo as the chemo makes you bleed.For some the shots work better for them.
I was diagnosed with mets to my liver before I got the blood clot and I have never had any problems with the warfarin effecting my cancer, pic line or anything else.
Candy

[MonaL]

I'm not that familiar with Avastin, but my impression is that it blocks the formation of new blood vessels so that the tumor(s) can't create a new blood supply -- it doesn't really block the blood itself.