The Hemostatic System and Malignancy

There is an intimate relationship between the processes involved in malignancy and hemostasis. The mechanisms by which malignancy promotes thrombosis are reviewed herein. Emphasis, however, is placed upon the potential mechanisms by which the hemostatic system modulates malignant potential of tumors. Both thrombotic and nonthrombotic processes related to the enhancement of tumor growth, angiogenesis, and metastases are presented. Also reviewed are the effects of anticoagulants such as vitamin K antagonists, heparin, and other glycosaminoglycans on survival of patients with cancer. As new anticoagulants and targeted anticancer therapies are developed, we can expect the interactions between coagulation and tumor biology to be an evolving and productive area for breakthroughs in basic science and clinical applications.