Pulmonary Embolism During Chemotherapy – Looking for Advice and Shared Experiences

Hi There
I've never heard of that happening during chemo.  Have you checked with the consultant to see what they say?

I had a pulmonary embolism in my right lung and it was from the blood test from that they discovered my PSA was over 380 and so......I'm here

I was put on Apixaban for like 5mg twice a day.

Good Luck

I have not heard from them yet. But I have an appointment with the oncologist in two days.

You were “lucky” to find out about the PSA being high, I wish you well. Thanks for your reply.

Good afternoon Mr U. I am glad to hear that you are just out of hospital following your PE and hope that you soon start feeling better at home, especially as you will be away from others on the ward who could possibly be infectious.

As I said on your blog, my husband also had PE's on February 24th 2025 so it is all new to me as well. I discussed the matter with our oncologist last Friday who said that men on hormone therapy have a higher risk of DVT and pulmonary embolism. Also, as hubby has had chemotherapy and 3 lots of radiotherapy his body has been put through a lot of treatment which could also have contributed to the PE. This then led me, the nerd, to start delving into it and it appears that it is pretty well documented - so why aren't we warned about it? Looking at chemotherapy and frequency then the numbers increase and more so with platinum based chemotherapy. Similarly for radiotherapy, but more so soon after completing the course which is why they recommend that you don't fly for a few weeks. Steve Stevecam guided me with his experience of a PE and the best anticoagulants which was very useful and helped me with the research as hubby also has CKD. As none of the tests could pinpoint the origin of the clot we have been advised that for 6 months hubby will be on Apixaban 5mg twice daily but with regular blood tests. If all is ok then this will be reduced to 2.5 mg twice daily. We were warned that the anticoagulants do not disperse the clot, they just reduced the risk of it getting bigger. It can take months for the clots to disperse naturally but it might not completely go and can cause a 'scar' to form. We have also been told that it can happen again.

Does it mean that chemotherapy is not an option - no. You will need to talk to the experts about timing and how you are going to be monitored in future with both blood tests and full body CT. When I asked specifically about blood tests whilst on anticoagulants I was told that hubby would continue with his 3 monthly ones but just with the D-Dimers and CRP as a precaution.

Hubby has a slight heart irregularity so he was on B blockers prior to chemotherapy in 2023 and remained on it for his SBRT in 2024 and additional radiotherapy for bone mets earlier this year. From what I can gather there is no predicting who will be the unfortunate one to have a PE. What we have to do is be vigilant, exercise and be careful with diet plus drink at least 1.5 to 2l fluid a day.

I don't think this has answered your questions but it does highlight that the experts are aware of it, how to deal with it, and can advise you what the best option is for you based on your type and extent of embolism.

If it wasn't for bad luck I'd have no luck at all ;-)

Today's a day for other people's quotes:

Slartibartfast said:

If it wasn't for bad luck I'd have no luck at all

Oh my that’s great detail. So like me your hubby was on beta-blockers, mine are for AFib (diagnosis 2020) and that’s part of my gripe. As a 60 year old with AFib why did no one think to mention the clot risk would be worse for me, especially as I’m not on any anticoagulant.

You mention scarring and the very slow process of clot reduction, was this from a cardiologist?

I am inquisitive too but not so academic so my worries come from judging the risks to the whole body not just for that particular part of the body, I’m not making sense. Perhaps a a GP might assess me not an oncologist would. My whole body has a clot risk factor because of my age and having AFib these last 5 years but an additional clot risk from Carboplatin (or any chemo) multiplies my rush surely.

I struggling with trust here and now, like I’m in shock. I’m not mad yet but becoming madder due to my increasing feeling that this “massive bilateral pulmonary embolism” was a big risk for me, and somehow someone should have thought to tell my GP or ask a cardiologist if I should first be prescribed rivaroxaban again. Note: I was taken off the anti-coagulant 3 years ago because my Chad-vascular score was zero.

I had a heart consultant tell me at the weekend that my Chad-vascular score is now two, which I didn’t think to question, but I am now.

I’m sorry to moan, I should (and will) talk to my GP about this I guess.

I’m knock off course just now.

It was the medical oncologist, GP,  vascular surgeon and cardiologist who all told me that the anticoagulants do not disperse the clot, they just stop it from getting bigger.

I am not sure that there is an increased risk of a PE if you have AF. B blockers actually reduce the risk of blood clots. The risk is from the hormone therapy and additional treatments for advanced prostate cancer. 

You can assess what has pushed you into the Chad-vascular score of 2 by entering your details into the algorithm on the computer - this might give you a better idea of whether it is as a result of the embolism or from a different cause.

Before any treatment I have to go through hubby's medical history and current drugs. It is a risk with any treatment and no predicting who will get what side effects.

Thanks Alwayshope,

It looks like I’m going thru the stages of grief today.

The chad vascular score 2 is just for the embolism by the look of it.

I hope to be in a position to calm down and put everything on hold so My Darling and I can plan ahead with “all” relevant information.

Take care 

 Mr U My Pulmonary Embolism started in my left leg as a DVT, then into both lungs.

I started on the injections until I had nowhere left to inject in my stomach.

Then onto Apixiban, 2x5mg a day.  For some reason they tried to put me on Rivaroxaban but I had some sort of reaction to it.

So it was back onto Apixiban 2x5mg.  After 6 months I was supposed to go onto 1x5mg but because of the epilepsy medicine I am on, I had to stay on the higher dosage.

Will be on it permanently.  My blood is like watered down Ribena, literally.

I know I had not received Chemotherapy, but back when I started on the Apixiban I was diagnosed with PC, but was put on Active Surveillance (for 4 years).

 Alwayshope has a lot of good knowledge and is well worth listening to.

I too have been advised to drink up to 2 litres of water a day.

Hope this is of some help.  I do waffle on a bit.

Take Care 

I waffle on a bit myself, you might have noticed.

Alwayshope is a font of knowledge and like most forum posters, positive and helpful.

Good luck, take care