Treatment for deep vein thrombosis (DVT) is recommended for all patients with advanced cancer in hospitals, yet it is not routine practice for those in specialist palliative care units, such as hospices.

The aim of this study was to determine how many cancer patients admitted to hospices have DVTs and whether these cause problems and will result in a better understanding of how we should treat people with advanced cancer.

About the project

Funder: NIHR Research for Patient Benefit
Time frame: 2015 to 2017: Completed
Publication: ISRCTN registry
Contact for more details: Professor Miriam Johnson and Dr Flavia Swan 

The purpose of this project was to estimate the prevalence of clinically relevant femoral vein deep vein thrombosis (DVT) in people with advanced cancer admitted to hospice.

Cancer patients admitted to five hospices in England, Wales and Northern Ireland had an ultrasound scan of both thigh and groin veins and asked about symptoms.

About a third had a DVT on admission; more likely in people who had been bedbound recently.

DVT prevention treatment on admission did not seem to prevent DVT, survival was unaffected and few developed a new DVT during their stay. DVT prevention measures on hospice admission may therefore have little benefit, and treatment of a DVT may not be helpful for such patients with few or no symptoms and advanced cancer.


Clare White, Simon I R Noble, Max Watson, Flavia Swan, Victoria L Allgar, Eoin Napier, Annmarie Nelson, Jayne McAuley, Jennifer Doherty, Bernadette Lee, Miriam J Johnson. Prevalence, symptom burden, and natural history of deep vein thrombosis in people with advanced cancer in specialist palliative care units (HIDDen): a prospective longitudinal observational study. The Lancet Haematology, Volume 6, Issue 2, 2019, Pages e79-e88, ISSN 2352-3026.