Grant: Project Grant

Patients with cancer often receive blood thinners to either treat or prevent blood clots, such as strokes or lung blood clots. They also often need biopsy procedures or cancer-related surgery to diagnose and treat their cancer. Blood thinner treatments need to be stopped temporarily around the time of surgery to avoid dangerous bleeding. Bleeding can lead to serious consequences for patients, is associated with a risk of death of 15% and can result in costs to the healthcare system of upwards of $75,000 CAD. Stopping blood thinners for too long can leave patients unprotected from blood clots. For these reasons, doctors follow specific management strategies for stopping and restarting blood thinners for surgery. These strategies have never been tested in patients with cancer and there is little data to guide doctors on how to best manage these patients. Different approaches to managing blood thinners might be needed for patients have cancer-related surgery, since cancer is a strong risk factor for both bleeding and clotting. The ACE-HIGH study will leverage international expertise in thrombosis medicine and innovative laboratory technology to determine whether current blood thinner management strategies are safe in patients having cancer-related surgery. The results of this study will help doctors better understand the risks involved for cancer patients needing surgery and will protect patients from life-threatening complications. We will determine whether current blood thinner management strategies can be safely applied to patients with cancer, or whether tailored approaches are needed. ACE-HIGH will lay the groundwork for a larger future trial aimed at comparing different blood thinner management strategies in patients with cancer.