Von Willebrand Disease (VWD) is a common inherited bleeding disorder. Many individuals with VWD and their families wonder about a potential link between VWD and cancer. This article provides clear, evidence-based information on whether VWD can cause cancer, addressing common misconceptions and outlining practical considerations for cancer care in individuals with VWD.
Understanding Von Willebrand Disease
Von Willebrand Disease is a genetic condition where the blood does not clot properly. This occurs due to a deficiency or dysfunction of von Willebrand factor (VWF), a protein important in the blood clotting process. VWF helps platelets stick to damaged blood vessel walls and also carries Factor VIII, another clotting protein. Since it is inherited, VWD is present from birth, though its symptoms vary widely in severity.
Common symptoms of VWD include easy bruising, frequent or prolonged nosebleeds, and excessive bleeding from cuts or after dental procedures. Women with VWD often experience heavy or prolonged menstrual bleeding. In more severe cases, individuals may have prolonged bleeding after surgery or injuries, or spontaneous bleeding into joints and muscles.
The Relationship Between VWD and Cancer
Von Willebrand Disease itself does not cause cancer. Research indicates that individuals with inherited VWD do not have an increased risk of developing cancer. Some studies have even suggested a lower incidence of certain solid tumors in VWD patients, possibly due to VWF’s role in angiogenesis, the formation of new blood vessels that tumors need to grow.
It is important to differentiate inherited VWD from acquired von Willebrand syndrome (AVWS), where VWD-like symptoms develop due to another medical condition, often cancer. In these cases, the cancer or its treatment leads to the acquired bleeding disorder, not the other way around.
AVWS is a rare bleeding disorder associated with various underlying conditions. These include lymphoproliferative disorders (e.g., chronic lymphocytic leukemia, non-Hodgkin lymphoma, multiple myeloma) and myeloproliferative neoplasms (e.g., essential thrombocythemia, polycythemia vera). Some solid tumors, like Wilms’ tumor and lung cancer, can also lead to AVWS. The mechanism often involves the cancer affecting the body’s von Willebrand factor or its clearance, leading to bleeding symptoms.
Navigating Cancer Care with VWD
Since VWD does not cause cancer, individuals with VWD should still undergo regular cancer screenings as recommended for the general population. If a person with VWD is diagnosed with cancer, it is essential to manage both conditions effectively.
Informing oncologists and other medical professionals about a VWD diagnosis is important to ensure safe and effective cancer care. Bleeding risks during diagnostic procedures, such as biopsies, or during cancer treatments like surgery or chemotherapy, must be carefully considered. Chemotherapy can lower platelet counts and affect platelet function, increasing the risk of bleeding in VWD patients. Collaboration between hematologists, who specialize in bleeding disorders, and oncologists is essential to manage potential bleeding complications. This multidisciplinary approach helps tailor treatment plans, incorporating therapies to control bleeding, such as von Willebrand factor concentrates or desmopressin, especially around invasive procedures.