Symptom Specific Services

Bleeding

When should I be concerned about bleeding?
Bleeding can occur in people with cancer. The two elements required to prevent bleeding are an adequate number of blood cells (called platelets) and sufficient blood clotting factors. Your doctors can measure both elements by taking a blood sample. The platelet count, usually in the range of 200,000 to 400,000, can go to levels below 20,000, which can lead to abnormal bleeding. The platelet count may go down because of either decreased production or increased consumption of platelets. Reduced platelet production may be a consequence of chemotherapy and/or radiation, or a consequence of your cancer involving the bone marrow. Increased platelet consumption may be a consequence of associated medical problems, such as serious infections.

If you notice any bleeding, particularly from the gums, nose, skin, urine, rectum, or any abnormal bleeding, you should notify your physician. If your platelet count is low, your doctor will determine the cause and in certain situations may give you a transfusion of platelets. Another cause of abnormal bleeding may be related to low levels of blood clotting factors. These clotting factors may be low due to certain medications, particularly Coumadin, or may be associated with abnormal blood clotting triggered by medical complications such as infection.

It is important to work with your physician to deal with abnormal bleeding at its earliest signs in order to reduce the risk of bleeding in vital structures such as the brain.

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