Grant: Project Grant

Due to medical advancements, patients with cancer are living longer; however, this results in metastatic bone disease (MBD) being more common, which can lead to cancer-associated fractures. These fractures often require surgical treatment. Both cancer and surgery are risk factors for developing blood clots in the legs (deep vein thrombosis or DVT) and blood clots in the lungs (pulmonary embolism or PE). These complications are the most common cause of death in patients with cancer, other than the disease itself, and often result in prolonged medical treatment and hospital stays. Patients with MBD who require surgery are given medication to help prevent blood clots; however, it is unknown which medication is best or for how long it should be continued. In order to prevent DVT/PE, doctors need to be able to understand how and why abnormal blood clotting occurs in MBD. Thrombelastography (TEG) technology uses a portable machine and a small sample of blood to evaluate a person's clotting ability. Platelets are a key component in the process of blood clotting, so we will use state-of-the-art imaging and specialized laboratory testing to understand how platelets are activated and how they behave. These techniques will be used to compare patients with cancer-associated blood clots to those who do not, to help determine which medications may be best to help prevent DVT/PE. Our multidisciplinary research team includes physicians, surgeons, and scientists with experience evaluating abnormal blood clotting. This study will use blood samples and ultrasound imaging of the legs to look for blood clots in patients with a broken bone due to cancer, both before and after surgical repair. We will measure individual blood clotting profiles to help determine the best medical treatment for preventing blood clots. If our study results determine that individualize care is warranted, this will help prevent DVT and PE, and will save the lives of patients with MBD across Canada.