A Nickel's Worth of Cancer
Authors: Deborah L. Ornstein
Journal: Annals of Internal Medicine (2008)

Editorials2 September 2008A Nickel's Worth of CancerDeborah L. Ornstein, MDDeborah L. Ornstein, MDFrom Yale University School of Medicine, New Haven, CT 06520-8070.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-5-200809020-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “A nickel's worth of cancer can give a dollar's worth of clot.” My mentor, Dr. Leo Zacharski, is fond of using this expression to describe the phenomenon of clinically overt venous thromboembolism (VTE) triggered by clinically occult cases of cancer. Although Armand Trousseau first described the association between cancer and thrombosis (1) and later developed cancer-associated thrombosis himself, it was Illtyd James and Matheson (2) who in 1935 first promulgated the idea that clinically inapparent cancer could trigger thrombosis. They reported on a seemingly cancer-free patient who developed symptomatic cancer 2 months after presentation with thrombosis and made the conjecture ...References1. Trousseau A. Clinique Medical de l'Hotel Dieu de Paris. London: The New Sydenham Society; 1865:94-96. Google Scholar2. Illtyd James T, Matheson N. Thrombo-phlebitis in cancer. Practitioner. 1935;134:683-4. Google Scholar3. Donati MB, Falanga A. Pathogenetic mechanisms of thrombosis in malignancy. Acta Haematol. 2001;106:18-24. [PMID: 11549773] CrossrefMedlineGoogle Scholar4. Zacharski LR, Wojtukiewicz MZ, Costantini V, Ornstein DL, Memoli VA. Pathways of coagulation/fibrinolysis activation in malignancy. Semin Thromb Hemost. 1992;18:104-16. [PMID: 1574711] CrossrefMedlineGoogle Scholar5. Varki A. Trousseau's syndrome: multiple definitions and multiple mechanisms. Blood. 2007;110:1723-9. [PMID: 17496204] CrossrefMedlineGoogle Scholar6. Prandoni P, Piccioli A. Thrombosis as a harbinger of cancer. 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Randomized comparison of low molecular weight heparin and coumarin derivatives on the survival of patients with cancer and venous thromboembolism. J Clin Oncol. 2005;23:2123-9. [PMID: 15699480] CrossrefMedlineGoogle Scholar14. Ornstein DL, Zacharski LR. The use of heparin for treating human malignancies. Haemostasis. 1999;29 Suppl S1 48-60. [PMID: 10629404] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Deborah L. Ornstein, MDAffiliations: From Yale University School of Medicine, New Haven, CT 06520-8070.Disclosures: None disclosed.Corresponding Author: Deborah L. Ornstein, MD, Department of Pathology, Yale University School of Medicine, PO Box 208070, New Haven, CT 06520-8070. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: The Trousseau Syndrome Revisited: Should We Screen Extensively for Cancer in Patients with Venous Thromboembolism? Marc Carrier , Grégoire Le Gal , Philip S. Wells , Dean Fergusson , Tim Ramsay , and Marc A. Rodger Metrics Cited bySystemic coagulation is activated in patients with meningioma and glioblastoma 2 September 2008Volume 149, Issue 5Page: 350-352KeywordsCancer epidemiologyCancer screeningComputed axial tomographyLow molecular weight heparinPelvisProphylaxisRandomized trialsThrombosisVenous thromboembolismVitamin K ePublished: 2 September 2008 Issue Published: 2 September 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...