Stroke May Signal Undetected Cancer

Exploring a higher rate of cancer in people who survive a stroke, a Minnesota research team recommends screening these stroke patients for cancer.

“Subclinical cancer can manifest as a thrombo-embolic event,” Adnan Qureshi MD, professor of neurology, neurosurgery, and radiology at the Zeenat Qureshi Stroke Institutes and Centracare Health, St. Cloud, Minn. said, discussing his study today at the American Heart Association/American Stroke Association International Stroke Conference in Nashville Tenn.

Quereshi and colleagues documented that patients with stroke showed significantly higher mortality than the general population, a trend that was not explained by stroke severity and deaths from cardiovascular causes.

That difference was explained by more cancer in these patients.

In a multi-center clinical trial, the team looked at 3,247 adults who had survived a non-disabling ischemic stroke. They found that 133 of these patients developed cancer over a 2-year period after the stroke. That translated to a rate of more than 1,500 cancer cases per 100,000 population while the expected rate in the general population would have been about 1,100 cases of cancer.

“We observed an annual rate of age-adjusted cancer incidence which appeared to be higher among ischemic stroke patients compared with the general population,” the researchers concluded. While many complex questions need to be explored—such as the role inflammation can play in both stroke and cancer—one simpler explanation is that many of those patients had cancer when they had the stroke, but that it had not been detected.

Cancers can trigger thrombo-embolic events, Quereshi said. He added that he found it interesting and unexpected that of the 133 cancers, 35.3% were skin cancer.

Prostate (18%) was the next most common. Discussing the study today, Quereshi said more cancer screening for these patients was a good idea—particularly in younger patients.