“As soon as you have a cancer diagnosis, the odds [of VTE] increase 4-fold, 6.5-fold if that particular patient is initiating chemotherapy.” Dr Marc Carrier and Dr Geoffrey Barnes use a case study to talk through the decision-making process and specific needs for anticoagulation in patients with cancer. They highlight the need for a multidisciplinary approach, how tools such as the Khorana score inform treatment, and the patient group that rarely receives thromboprophylaxis despite having a number needed to treat of just 25 to prevent one clot.