Blood Clots in Urine: Causes and Concerns for Cancer Patients

Q: Blood Clots in Urine: Causes and Concerns for Cancer Patients

Hello： 1. <br>I would like to ask the doctor if it is possible that cancer cells have metastasized, or if there is another new cancer? --> A CT scan has been performed on the bladder, kidneys, and prostate, and the doctor indicated that there are no significant issues with the ki

Causes of Blood Clots in Urine

Hello doctor, I am inquiring on behalf of my elderly family member.
My grandfather is currently suffering from gastric cancer, which is at an advanced stage.
He has undergone surgery and is currently receiving chemotherapy.
A CT scan to check for metastasis showed no significant issues (he had his entire stomach and spleen removed, along with a small segment of the small intestine).
Recently, he has been experiencing blood clots in his urine, but there is no visible hematuria.
He is asymptomatic and does not feel any pain or discomfort.
He has benign prostatic hyperplasia and has experienced a decline in kidney function, which is being managed with medication.
1.
I would like to ask the doctor if it is possible that the cancer cells have metastasized, or if he could have developed another new cancer? The kidney function has been monitored with regular blood tests, and the doctor has indicated that there are no significant issues.
2.
I would also like to ask the doctor what we should check in urology.
Initially, when he was diagnosed with gastric cancer, all tests came back normal, but he had been losing weight and vomiting, which delayed the diagnosis for six months.

Jiahao, 80~89 year old female. Ask Date: 2021/12/10

Dr. Jian Weihong reply Urology

Hello: 1.
I would like to ask the doctor if it is possible that cancer cells have metastasized, or if there is another new cancer? --> A CT scan has been performed on the bladder, kidneys, and prostate, and the doctor indicated that there are no significant issues with the kidneys, as I have been undergoing regular blood tests.
2.
I would like to ask the doctor what we should check in urology.
Initially, when I was diagnosed with stomach cancer, all tests showed no issues, but I continued to lose weight and vomit, leading to a diagnosis six months later --> If urination is still normal, I can discuss this with the physician during my follow-up appointment and inquire about any effects of chemotherapy.
However, if there is persistent hematuria, or if I experience blood clots and difficulty urinating, I should seek urological care as soon as possible.
Wishing you good health.

Reply Date: 2021/12/10

More Info

Blood in the urine, particularly in the form of blood clots, can be a concerning symptom for any patient, especially those with a history of cancer such as gastric cancer. In the case of your grandfather, who is undergoing treatment for advanced gastric cancer and has a history of prostate enlargement and declining kidney function, it is essential to consider several potential causes for the blood clots in his urine.

1. Potential Causes of Blood Clots in Urine:
- Cancer Metastasis: While the presence of blood clots can be alarming, it does not automatically indicate that cancer has metastasized to the urinary tract. However, in cancer patients, any new symptom should be evaluated carefully. The risk of metastasis to the bladder or kidneys exists, especially in advanced cancer cases.
- Prostate Issues: Given that your grandfather has benign prostatic hyperplasia (BPH), this condition can lead to urinary symptoms, including blood in the urine. The enlarged prostate can cause irritation or trauma to the urinary tract, leading to bleeding.

- Kidney Function: Since there is a noted decline in kidney function, it is crucial to monitor this closely. Kidney issues can sometimes lead to hematuria (blood in urine) due to various reasons, including infections or kidney stones.

- Infections: Urinary tract infections (UTIs) can cause bleeding, and while your grandfather may not currently exhibit symptoms of a UTI, it is still a possibility that should be ruled out.

- Medication Effects: If your grandfather is on anticoagulants or certain medications, these could also contribute to bleeding in the urinary tract.

2. Recommended Actions:
- Consult a Urologist: Given the complexity of your grandfather's medical history and the new symptom of blood clots in the urine, it is advisable to consult a urologist. They can perform a thorough evaluation, which may include:
- Urinalysis: To check for signs of infection, blood, or other abnormalities.

- Imaging Studies: Such as an ultrasound or CT scan of the kidneys and bladder to look for any structural issues or masses.

- Cystoscopy: This procedure allows direct visualization of the bladder and urethra, which can help identify any lesions or sources of bleeding.

3. Monitoring and Follow-Up:
- Regular follow-ups with both the oncologist and urologist are essential. Given your grandfather's history of gastric cancer, any new symptoms should be monitored closely, and any changes in his condition should be reported to his healthcare team immediately.

- It is also crucial to keep track of any other symptoms that may arise, such as changes in urinary habits, pain, or any systemic symptoms like fever or weight loss.

4. Psychological Support:
- Dealing with cancer and its complications can be emotionally taxing for both the patient and the family. Consider seeking support from counseling services or support groups for cancer patients and their families.

In conclusion, while blood clots in the urine can be concerning, they do not necessarily indicate a new cancer diagnosis or metastasis. However, given your grandfather's medical history, it is crucial to pursue further evaluation to determine the cause and ensure appropriate management. Early detection and intervention can significantly impact outcomes, especially in cancer patients.

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