Efficacy and safety of oral anticoagulation in patients with cancer.

The treatment of venous thrombosis in patients with cancer is a common clinical problem. It appears that long term oral anticoagulant therapy with coumadin does not carry a significantly increased risk of major bleeding compared with the risk in patients without cancer. However, the risk of recurrent thrombosis in these individuals appears to be higher than in those patients without cancer. Nevertheless, the treatment of most patients with cancer and venous thrombosis with standard anticoagulant therapy is reasonable. Prospective, randomized trials are required to determine the optimal therapy for these patients, and, in particular, those that have failed traditional anticoagulation.