Bleeding during cancer treatment

Your bone marrow makes cells called platelets. These cells keep you from bleeding too much by helping your blood clot. Chemotherapy, radiation, and bone marrow transplants can destroy some of your platelets and the cells in your bone marrow that make them. This can lead to bleeding during cancer treatment.

What to Expect

If you do not have enough platelets, you may bleed too much. Everyday activities can cause this bleeding. You need to know how to prevent bleeding and what to do if you are bleeding.

Self-care

Talk with your health care provider before you take any medicines, herbs, or other supplements. Do not take aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve), or other medicines unless your provider tells you it is OK.

Be careful not to cut yourself.

• Do not walk barefoot.
• Use only an electric razor.
• Use knives, scissors, and other tools carefully.
• Do not blow your nose hard.
• Do not cut your nails. Use an emery board instead.

Take care of your teeth.

• Use a toothbrush with soft bristles.
• Do not use dental floss.
• Talk with your provider before getting any dental work done. You may need to delay the work or take special care if you have it done.

Try to avoid constipation.

• Drink plenty of fluids.
• Eat plenty of fiber with your meals.
• Talk with your provider about using stool softeners or laxatives if you are straining when you have bowel movements.

To further prevent bleeding:

• Avoid heavy lifting or playing contact sports.
• Do not drink alcohol.
• Do not use enemas, rectal suppositories, or vaginal douches.

Women should not use tampons. Contact your provider if your periods are heavier than normal.

If you cut yourself:

• Put pressure on the cut with gauze for a few minutes.
• Place ice on top of the gauze to help slow the bleeding.
• Contact your provider if the bleeding does not stop after 10 minutes or if the bleeding is very heavy.

If you have a nosebleed:

• Sit up and lean forward.
• Pinch your nostrils, just below the bridge of your nose (about two-thirds down).
• Place ice wrapped in a washcloth on your nose to help slow the bleeding.
• Contact your provider if the bleeding gets worse or if it does not stop after 30 minutes.

When to Call the Doctor

Contact your provider if you have any of these symptoms:

• A lot of bleeding from your mouth or gums
• A nosebleed that does not stop
• Bruises on your arms or legs

  Bruises

  A bruise is an area of skin discoloration. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the s...

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• Small red or purple spots on your skin (called petechiae)

  Petechiae

  Bleeding into the skin can occur from broken blood vessels that form tiny red dots (called petechiae). Blood also can collect under the tissue in la...

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• Brown or red urine
• Black or tarry-looking stools, or stools with red blood in them
• Blood in your mucus
• You are throwing up blood or your vomit looks like coffee grounds
• Long or heavy periods (women)
• Headaches that do not go away or are very bad

  Headaches

  A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...

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• Blurry or double vision
• Abdominal pains