What Is Bleeding and What Are Its Symptoms?

Bleeding is blood leaving the heart and vessels where it normally circulates. In other words, disruption of vessel integrity allows blood to escape and flow inside or outside the body. Its importance depends on rate, location and amount.

Bleeding can occur anywhere: skin cuts, the nose, hemorrhoids, or internal organs such as the lungs, brain, stomach or bladder.

Slow bleeding may have little effect, though tiredness and fatigue can occur. Unexpected sudden bleeding, however, may cause severe weakness, dizziness and pain.

When Does Bleeding Occur?

What Are the Risk Factors for Bleeding in Cancer Patients?

Chemotherapy drugs affect bone marrow's ability to produce platelets. Platelets stop bleeding by allowing blood to clot. If levels are insufficient, even minor injuries can cause skin bleeding or easier bruising than normal. Some chemotherapy drugs are more likely than others to cause thrombocytopenia (low platelets).

Cancer drugs commonly associated with thrombocytopenia include:

• Platinum-based chemotherapies: carboplatin, cisplatin and oxaliplatin
• Gemzar (gemcitabine)
• Taxol (paclitaxel, docetaxel)

Immunotherapies may rarely cause thrombocytopenia. Certain targeted drugs in the tyrosine kinase inhibitor class that prevent angiogenesis (new vessel formation) can also increase bleeding tendency.

Another situation concerns patients requiring regular blood thinners, such as coumadin, because of their diseases. They are at risk of bleeding. Coumadin users should also be careful with, and avoid excessive consumption of, these plant foods: garlic, flaxseed, ginger, green tea, poplar buds, turmeric and motherwort may increase the effects of anticoagulants such as coumadin and cause bleeding. Patients should be cautious. 

How Can We Prevent Bleeding?

• Avoiding certain triggers of bleeding protects you from infections caused by contagious bacteria and parasites during cancer treatment and prevents blood loss.
• Do not take aspirin or aspirin-containing painkillers without consulting your doctor.
• Do not drink alcohol without your doctor's approval.
• Use an electric shaver.
• Trim and file your nails.
• Use skin lotion to relieve dryness.
• Brush teeth with a very soft toothbrush.
• Clean your nose with a tissue. Do not use your fingers.
• Be careful when using sharp tools and knives.
• Avoid burns while cooking or ironing. Use oven gloves when reaching into a hot oven.
• Avoid contact sports and activities that may cause injury.
• Wear gardening gloves when digging soil or planting.

Signs and Symptoms of Bleeding:

• Skin: Small red spots resembling a rash and bruising on the feet and legs.
• Eyes: Bleeding in the whites of the eyes and impaired vision.
• Mouth and nose: Blood pooling, bleeding gums, bloody saliva, bleeding mouth sores, nosebleeds.
• Digestive system: Blood in vomit or stool.
• Urinary and genital organs: Blood in urine, burning and bleeding during urination, frequent recurrent cramps, heavier-than-normal vaginal bleeding (or bleeding after menopause)
• Other: Severe headache, dizziness, weakness, difficulty waking, muscle and joint pain.

Consult Your Doctor

Consult your doctor promptly if you have the signs or complaints above. Never follow hearsay advice on your own without your doctor's knowledge. Your doctor will perform necessary tests and take precautions.