Patients with cancer have a 4-7 fold increased risk of venous thromboembolism (VTE). Long-term VTE treatment is different in cancer patients than patients without cancer. Low molecular weight heparin (LMWH) is more effective than vitamin K antagonists (e.g., warfarin) in reducing the risk of recurrent VTE in cancer patients (while on therapy), and they do not significantly increase the risk of bleeding. However, LMWH is not associated with improved survival in these patients.
Though more effective, other factors must be taken into consideration when prescribing LMWH, such as patient preference (e.g., needle vs. pills), comorbidities (e.g., renal insufficiency), and cost (e.g., copays).