Bleeding Problems

Approved by the Cancer.Net Editorial Board, 09/2016

A bleeding disorder occurs when blood does not clot fast enough. This results in too much bleeding or bleeding that lasts a long time.

Normal blood clotting is called coagulation. This complex process involves platelets and clotting or coagulation factors. 

  • Platelets are special blood cells.

  • Clotting or coagulation factors are types of protein in blood.

Platelets and coagulation factors clump together to heal broken blood vessels. This helps control bleeding. A delicate balance of coagulation factors promote healthy bleeding and clotting.

Blood clotting disorders occur when:

  • Clotting factors are missing or damaged.

  • The blood has too few platelets.

  • Platelets don't work correctly.

Learn more about clotting problems.

Symptoms of bleeding problems

People with bleeding disorders may experience the following symptoms:

  • Cuts that bleed excessively

  • Unexpected or sudden bruising

  • Small purple or red spots under the skin. These are called petechiae.

  • Blood in vomit. It often resembles coffee grounds.

  • Black or bloody bowel movements

  • Red or pink urine

  • Dizziness, headaches, or changes in vision

  • Joint pain

  • Gum bleeding

  • Heavier- or longer-than-usual menstrual periods in women

Talk with your health care team about any symptoms you experience. In particular, mention new symptoms or a change in symptoms.

Causes of bleeding problems

Sometimes a person inherits a bleeding disorder. This means it is genetic and runs in the family. Other bleeding problems result from illness or treatment with specific drugs.

Causes of bleeding problems include the following:

  • Inherited disorders. Hemophilia and von Willebrand’s disease are 2 types. With hemophilia, blood doesn't clot normally. With von Willebrand's disease, clotting factors are missing or do not work well.

  • Vitamin K deficiency

  • Cancer that begins in or spreads to the liver

  • Other liver disorders. These include hepatitis and cirrhosis. Hepatitis is an infection of the liver. Cirrhosis is scarring of the liver.

  • Long-term use of powerful antibiotics or anticoagulants. Anticoagulants are medications that thin the blood.

  • Drugs called angiogenesis inhibitors. These prevent the growth and development of new blood vessels.

  • Thrombocytopenia, which is an unusually low level of platelets

  • Anemia, which is an unusually low level of red blood cells

  • Other disorders unrelated to cancer

Diagnosing bleeding problems

Your doctor will review your medical history and perform a physical examination. And, a nurse or laboratory technician will draw blood. The blood will be used for several blood tests:

Treating bleeding problems

Treatment to relieve symptoms and side effects is an important part of cancer care. This approach is called supportive or palliative care. It helps meet the patient’s physical, emotional, and social needs.

When possible, doctors treat a bleeding disorder’s underlying cause, such as cancer or liver disease.

These are additional treatments:

  • Vitamin K injection

  • Drugs that help blood to clot

  • Blood plasma or platelet transfusions

  • Other medications to treat platelet problems. These include hydroxyurea (Droxia, Hydrea) and oprelvekin (Neumega).

More Information

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