Medical Oncologist
CION Cancer Clinics
Preventing blood clots after cancer surgery | CION Cancer Clinics
Cancer and major surgery both make blood clots more likely, so most people are assessed before the operation and given blood-thinning injections, compression stockings, leg pumps or a mix of these, alongside early walking. Some continue injections at home. This page explains each measure, when it starts and stops, who cannot have blood thinners, and the signs of a clot that need help at once. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- How are blood clots prevented after cancer surgery?
- What are the ways clots are prevented?
- When does clot prevention start and stop?
- What do people get wrong about clot injections?
- What do the clot words on your notes mean?
- Who cannot have blood thinners, and what can this page not tell you?
- Common questions about blood clots after surgery
The short answer
How are blood clots prevented after cancer surgery?
Blood clots are prevented with a mix of blood-thinning injections, stockings or leg pumps, and getting you moving early. Cancer and major surgery both make clots more likely, so most people having cancer surgery are assessed and given at least one of these.
Why cancer surgery raises the chance of a clot
A clot in a deep vein of the leg is called a deep vein thrombosis, or DVT. Three things make it more likely: blood moving slowly because you are lying still, blood that clots more easily, and damage to veins during the operation. Cancer itself makes the blood clot more readily. Long operations on the abdomen and pelvis, older age, being overweight and a past clot add to that.
Why it matters
A clot in the leg can cause pain and swelling. The bigger worry is a piece breaking off and travelling to the lungs, called a pulmonary embolism. That is a serious emergency. Prevention is far easier than treatment, which is why the team takes it seriously even when you feel well.
Your team assesses your own clot risk and your bleeding risk. The plan is balanced between the two.
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Signs of a clot that cannot wait
Sudden breathlessness, chest pain that is worse when you breathe in, coughing up blood, a racing heart or collapse can mean a clot in the lungs. In hospital, press the call bell. At home, go to the nearest emergency department at once. Pain, swelling, warmth or redness in one calf or thigh needs the surgical team the same day. Do not rub or massage a painful, swollen leg.
Not sure whether this applies to you?
Ask an oncologistWhat the team uses
What are the ways clots are prevented?
Most people get more than one. Which ones you get depends on your operation, your bleeding risk and your other health conditions.
Blood-thinning injections
A small injection given just under the skin of the tummy, on a schedule your team sets. The most common type is low molecular weight heparin, such as enoxaparin (sold in India under names like Clexane) or dalteparin.
Your team sets the dose and how long it continues. Never change or stop it yourself.Compression stockings
Tight, measured stockings that gently squeeze the legs and help blood flow back to the heart. They are not suitable for everyone, so they are fitted after a check.
Leg pumps
Soft sleeves wrapped around the calves that inflate and deflate in turn, doing the work of your calf muscles while you are in bed or during the operation.
Moving and drinking
Walking early, ankle exercises in bed and drinking enough fluids once allowed all keep blood moving.
In bed, every hour you are awake
- Point and flex your feet
- Circle your ankles
- Tighten and relax your calf muscles
The pathway
When does clot prevention start and stop?
A common pattern. Your own timing is set by your surgeon and anaesthetist.
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Before the operation
Your risk of clots and bleeding is assessed. You may be measured for stockings. Tell the team about any past clot and every blood-thinning medicine you take, such as aspirin, clopidogrel or warfarin.
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During the operation
Leg pumps are often used while you are asleep. The timing of the first injection is planned around the anaesthetic and any spinal or epidural injection.
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On the ward
Daily injections, stockings or pumps, and getting out of bed early. The team checks your wound and blood tests for signs of bleeding.
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Going home
After some cancer operations, particularly on the abdomen or pelvis, injections continue at home for a period. You or a family member will be taught to give them, and told exactly when to stop.
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Commonly believed
What do people get wrong about clot injections?
"I am walking now, so I can stop the injections."
Walking lowers the risk but does not remove it. Cancer keeps the blood more likely to clot for some time after surgery. Keep going until the team tells you to stop, even if you feel well.
"The bruises mean the injection is harming me."
Small bruises around injection sites are very common and expected. Change the spot each day. Tell the team about large or spreading bruises, bleeding that will not stop, or blood in urine or stools.
"Blood thinners will make the wound bleed."
The dose used for prevention is planned to lower clot risk while keeping bleeding risk low. The team watches your wound and blood tests and will change the plan if bleeding becomes a concern.
"A clot would be obvious, so we would know."
Many clots in the leg cause few or no symptoms at first. That is why prevention is given to people who feel completely well.
On your notes
What do the clot words on your notes mean?
- DVT
- Deep vein thrombosis: a blood clot in a deep vein, usually in the calf or thigh.
- PE
- Pulmonary embolism: a clot that has travelled to the lungs. It needs emergency care.
- VTE
- Venous thromboembolism: the term covering both DVT and PE.
- LMWH
- Low molecular weight heparin: the blood-thinning injection most often used to prevent clots.
- IPC
- Intermittent pneumatic compression: the inflating leg sleeves, also called leg pumps.
Being straight with you
Who cannot have blood thinners, and what can this page not tell you?
Blood-thinning injections do not suit everyone. They may be held back or delayed if you are bleeding, have a very low platelet count, have severe kidney problems, or have had a recent bleed in the brain. In those cases the team relies more on leg pumps, stockings and moving. Stockings in turn are not suitable for people with poor circulation in the legs or fragile skin.
Tell the team about your medicines
If you already take aspirin, clopidogrel, warfarin, apixaban, rivaroxaban or any other blood thinner, the plan for stopping and restarting it around surgery is made by your surgeon, anaesthetist and the doctor who prescribed it. Do not stop or restart any of these on your own. Bring all your medicine strips to the pre-surgery visit.
What we cannot tell you here
This page cannot tell you your own clot risk, which measures you need, what dose is right, or how long injections should continue. Those depend on your operation, your cancer, your kidneys and your bleeding risk. Ask your team: what is my clot plan, how long does it last, and who do I call if I miss an injection?
Questions we are asked
Common questions about blood clots after surgery
Why do I need injections when I am already walking?
Walking helps, but cancer and major surgery both make the blood clot more easily, and that risk lasts beyond the first few days. The injections lower the risk in a way walking alone cannot. Your team decides when it is safe to stop. Keep going until they tell you.
How do I give the injection at home?
A nurse will show you or a family member before you leave. The injection goes into the skin fold of the tummy, away from the wound and the belly button, changing sides each day. Do not rub the spot afterwards. Ask for a written sheet and practise once in front of the nurse.
What if I miss an injection?
Do not double up the next one. Call the surgical team or the number on your discharge sheet and ask what to do. They will tell you whether to give it late or wait for the next one. Setting a daily phone reminder at the same time helps avoid missed doses.
Is bruising around the injection normal?
Yes, small bruises and a little stinging are very common. Rotating the site helps. Call the team if you notice large or spreading bruises, bleeding from the gums or nose that does not stop, blood in urine, black stools, or a wound that starts bleeding.
Can I travel home to my district by car or bus after surgery?
Usually yes, once you are discharged. Long journeys sitting still raise clot risk, so stop every so often to walk about, do ankle exercises while seated, and drink water. Wear stockings if they were advised. Tell your team about a long journey before you leave, so they can plan around it.
I take aspirin for my heart. Should I stop it before surgery?
Do not stop it on your own. For some people, stopping aspirin is more dangerous than continuing it. Your surgeon, anaesthetist and the doctor who prescribed it decide together whether and when it should pause. Tell the team about it at the first pre-surgery visit.
Can a clot happen after I go home?
Yes. Clots can form in the weeks after cancer surgery, not only in hospital. Keep moving, keep up any injections and stockings you were given, and know the warning signs. Sudden breathlessness or chest pain needs the emergency department at once; a painful, swollen calf needs the team the same day.
Are the injections covered by insurance or schemes?
Medicines given during a hospital stay are usually part of the treatment bill that insurance and schemes such as Aarogyasri, CGHS, ECHS and EHS consider. Cover for injections continued at home varies. Ask the billing desk before discharge what your own policy or scheme covers.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- NICE — Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism (NG89)
- NHS — Deep vein thrombosis (DVT)
- NHS — Pulmonary embolism
- National Cancer Institute — Side effects of cancer treatment
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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