Bleeding

What is bleeding?

Bleeding is when blood is lost from a blood vessel. It can happen outside the body, such as from a cut, nosebleed, or bleeding gums, or inside the body. Internal bleeding can occur in places such as the stomach, intestines, lungs, brain, or bladder. In patients with cancer, bleeding can range from mild bruising or spotting to serious bleeding that requires urgent treatment.

What does bleeding look like?

Bleeding can look different depending on where it occurs. A patient may have minor bleeding, such as bruising, nosebleeds, or bleeding gums. Signs of more serious bleeding include blood in the urine, black or tarry stools, red blood in the stool, coughing up blood, or vomiting blood. Internal bleeding is harder to detect and may present as weakness, dizziness, fainting, or a severe headache.

Who gets bleeding?

In patients with cancer, bleeding is commonly linked to low platelet counts. Platelets are blood cells that help stop bleeding by forming clots. Cancer itself, especially cancers involving the bone marrow, can lower platelet counts, as can treatments such as chemotherapy and some targeted therapies.

Some patients are also at higher risk due to other medications or medical conditions. Patients who take blood thinners, or those with clotting disorders, liver disease, ulcers, or inflammation in the stomach or intestines, may have an increased risk.

How is bleeding prevented?

One important step in preventing bleeding is reducing the risk of injury. Patients at risk should avoid activities that can lead to cuts or falls, use a soft toothbrush, be gentle when blowing their nose, and be cautious with sharp objects. Patients may also be advised to avoid medicines that can worsen bleeding unless approved by their doctor.

In patients with cancer, prevention also includes monitoring blood counts. If platelet levels become dangerously low, a platelet transfusion may be needed to reduce the risk of serious bleeding.

How is bleeding treated?

Treatment depends on where the bleeding occurs, how much blood is lost, and the underlying cause. Minor bleeding may be treated with direct pressure and close observation. If bleeding is severe, the patient may require urgent hospital care, as significant blood loss can lead to shock, organ damage, or death if not treated promptly.

If the cause is low platelets, treatment may include a platelet transfusion. If bleeding is related to a medication, the healthcare team may stop or adjust that medication. If bleeding originates from the stomach, intestines, bladder, or another organ, additional tests and targeted treatments may be needed to identify and control the source.