Pulmonary Embolism During Chemotherapy – Looking for Advice and Shared Experiences

Hi Mr U,

I was in hospital for 10 days with a PE after surgery in 2018. I have also been hospitalized twice overnight in 2023 and twice overnight in 2024 since my diagnosis in March 2020. The consultant thought I might be predisposed to PEs as my mother died from one after surgery a number of years ago. I am now on 5mg Apixiban twice daily for life. Regarding your questions, I have developed 4 PEs on my lungs after my treatment started. I am not on chemotherapy but hormone injections and Abiraterone tablets. I have never been diagnosed with Atrial Fibrillation. I was not offered blood thinners before my cancer treatment started. I was on Rivaoxiban for 6 months after my PE in 2018 though. Finally, I have never had chemotherapy (yet). Hope this post helps in some way.

Take care, Tom.

Your information is very welcome and helps me understand what might be in store.

My mum was on warfarin for over 25 years and it stoped her one only DVT for ever.

I’m finding it hard to believe in my existing treatment plan and I’m clutching at straws to help me move on.

I feel damaged by my own choices and wish I had the foresight to ask these questions before starting chemo.

Take care.

Good morning Mr U . I hope you are feeling OK this morning. Hindsight is great and wouldn't we all like to have a crystal ball which allows us to choose the right treatment route for us. For those of us who have a cancer which refuses to lie down and die we have to make choices between quality of life and undergoing treatments which can have adverse effects on the health in the hope that it will gain us more time with our loved ones, but at a cost. The doctors weigh up many factors before offering treatment - they are the experts but this is usually based on the patients current health along with their attitude to living. From what I have read AF is a risk factor for pulmonary embolism, as is HT, radiotherapy and chemotherapy but how big a risk when compared to the chance of either a cure or prolongation of life? Should you have been put back onto anticoagulants before chemotherapy - your scores indicate that you were stable so it would be a toss up between possible side effects from the anticoagulants and the possible chemotherapy side effects. The operative word is 'possible'. If you are anything like my husband the PE has made him feel very vulnerable and he is also questioning whether he wants chemotherapy if it is offered, especially as he is feeling so good at the moment. I want him with me for as long as possible but I want him happy and living life, not just existing. Don't waste time and energy looking back at what should or might have been. Take the information that you now have to ask the experts the questions so that you can make the right decision for you and Mrs U going forwards.

With the injections make sure that you alternate which side of the stomach they are given but hubby did end up with a lot of bruising. He was also told to take Nexium an hour before breakfast because of the increaed risk of a GI bleed as well as given guidance on what painkillers could be used.

I look forward to your next blog, they make me smile and we all need that in our lives so carry on and thank you.

Wise words Always hope.

Ive had a good sleep and think. Concentrating on the future is today’s theme, just like you’ve suggested.

I’m so glad you take the time to explain in full in your replies, I’m so grateful  

Another question, did your hubby get any belly aches with the belly infections of the blood thinner?

I’m starting to get an ache but it’s not enough for pain relief. My thinking is that the injections might be the cause.

If it continues I will mention it at tomorrow morning’s consultation.

Take care 

No belly aches but don't forget that the chemotherapy could be upsetting the system. Watch your diet, especially full fat dairy and red plus processed food along with undercooked eggs and unpasteurised products. Exercise as much as you can.

Mr U, I use to injest one side one time, then change to the other side.  Sometimes I could hardly feel the needle go in, but sometimes it was so tender and painful...and my stomach, where I had injections went hard for a time.

Also I looked like a wasp, bruising all purple and yellow.

Nothing goes hard anymore...but I won't go into that!

I'd definitely mention it at your consultation.

Meant to say inject (bloody predictive text).

Thanks for your explanation or your experience, it really helps.

The belly of a wasp is where I’m heading too.

I will mention it and monitor it as per normal.

HT humour is essential, I’m a softie too.

Mr U said:

HT humour is essential

It certainly is!  It's what keeps us going!