The Skinny About Blood Thinners During Active Treatment

I'm thankful for my blood clots. They presented themselves inside both lung cavities, and they are the reason why my ovarian cancer was discovered early. I visited the ER because I couldn't breathe and I had pain in my chest and upper back.

For some sub-types of ovarian cancer, blood clots are produced while the cancer is spreading. The subtype that I had was endometrioid ovarian cancer. The subtype was not only found in both my ovaries but was also found in the endometrial lining of my uterus.

What are blood clots?

Blood clots that show up in the lung cavities are called pulmonary embolisms (PE's) and can be fatal if left untreated. The most common IV blood thinner is called heparin. If you go to the hospital and a PE is discovered you're immediately put on heparin to start dissolving blood clots. This is what happened to me.^1,2

Heparin and enoxaparin

IV heparin is a strong blood thinner and works instantly. A noticeable side effect is I had red flushing in my face. When being discharged from the hospital, you're transitioned to another blood thinner. If ovarian cancer was found, the drug of choice is enoxaparin (Lovenox). Enoxaparin is an injectable blood thinner.

Usually, the shot is done in the abdomen and is done once per day. The needle is very thin and small. There is a short life of Lovenox which is why oncologists like using enoxaparin. By short life, I mean the drug needs to be injected every 24 hours as it wears off. If you need a surgical procedure done right away, you only need to miss 1 dose and can have the procedure done the very next day.³

Time is key for blood thinners

Cancer cells replicate rapidly, and oncologists know that "time" is of great importance. Time is vital. Oncologists want to stay "ahead" of cancer cells growing. If waiting another day for a procedure because you're on a more advanced and powerful blood thinner, such as Eliquis, you need to miss 2 days (a 48-hour delay) before a surgical procedure.

I didn't like being on Lovenox. The injections were every single day (I really sympathized with insulin-dependent diabetics), and I felt sluggish. I bruised easy and my stomach sometimes had bruises near the injection site. I could also feel my skin change. It became thinner.

Many women who have ovarian cancer and have a radical hysterectomy can sometimes develop a blood clot. Ovarian cancer is abdominal cancer, and there is a large blood supply inside the abdominal cavity. To offset a blood clot risk post-surgery, an oncologist might prescribe Lovenox for a short time.

Chemotherapy can also produce blood clots. And if an active cancer patient develops one, Lovenox will also be prescribed for the remainder of the treatments.⁴

My experience with blood thinners

When I met my oncologist for the first time during the initial consult, she alerted me I would be on a blood thinner for 1 year. There were so many blood clots in both lung cavities (primary and secondary blood vessels) that she would "feel better" if a full year of anti-coagulation medication was taken.

During that time, I had several procedures done without any bleeding issues. Those procedures included a biopsy, chemo chest port install, 6 rounds of chemotherapy, and a radical hysterectomy.

After I was declared NED, I advocated going to a different blood thinner. I had only reached 6 months of my 12-month anti-coagulation therapy. I was tired of the daily injections, and so my oncologist suggested the oral medication, Eliquis.

I loved being on Eliquis. Zero side effects! No sluggish feeling. No bruising, and the only disadvantage is you have to remember to take it twice per day.