Prostate Cancer Treatment: Blood Thinner Concerns Allayed in New Study
New research offers reassurance to patients with advanced prostate cancer undergoing treatment with androgen-receptor pathway inhibitors. A study published in CANCER, a peer-reviewed journal of the American Cancer Society, found no increased risk of bleeding or clotting for those also taking anticoagulant medications.
The Risk of Thromboembolism in Cancer Patients
Thromboembolism – the formation of a blood clot that obstructs blood flow – is a significant concern for individuals with cancer, ranking as the second leading cause of death in this population, surpassed only by cancer progression itself. The American Cancer Society emphasizes the importance of managing this risk.
Androgen-Receptor Pathway Inhibitors and Anticoagulant Interactions
Patients with advanced prostate cancer often receive androgen-receptor pathway inhibitors, such as enzalutamide, apalutamide and abiraterone. Laboratory studies had previously suggested a potential interaction between these inhibitors and certain anticoagulants, specifically direct oral anticoagulants (DOACs), raising concerns about increased clotting risks.
Study Findings: No Increased Risk Observed
Researchers at the University of Ottawa at The Ottawa Hospital and the Ottawa Hospital Research Institute conducted a retrospective analysis of 2,997 Canadian adults with prostate cancer. The study, spanning from 2012 to 2023, evaluated patients prescribed both anticoagulants (DOACs or non-DOACs) and androgen-receptor pathway inhibitors. The findings, published in February 2026, revealed no increased risk of clotting in patients taking DOACs compared to those taking non-DOACs. Similarly, no increased risk of bleeding was observed when comparing DOAC and non-DOAC groups combined with abiraterone.
Implications for Clinical Practice
“As clinicians, we are faced with the question of choosing the best anticoagulant option for patients on a daily basis, and the complexity further increases in patients with cancer taking many other medications including anticancer therapies that could cause concerning drug–drug interactions,” said Dr. Tzu-Fei Wang, lead author of the study. “Our findings suggest that pharmacokinetic drug–drug interaction concerns may not translate into adverse clinical outcomes in the real world. These results can help clinicians and patients feel more confident when managing anticoagulation alongside modern prostate cancer treatments.”
Prostate Cancer Resources
For patients and families seeking more information about prostate cancer, the Prostate Cancer Foundation offers valuable resources, including guides and updates on research. Additional cancer resources for Michigan communities are available through the Michigan Department of Health and Human Services.
Source: Wang, T., et al. (2026). Risks of thrombosis and hemorrhage in concurrent use of anticoagulants and potential interacting prostate cancer agents. Cancer. DOI: 10.1002/cncr.70266.