Nosebleeds are a common side effect experienced during chemotherapy. While they can be a nuisance, these occurrences are often manageable. Understanding their causes can help individuals undergoing treatment feel more prepared.
Understanding the Link Between Chemotherapy and Nosebleeds
Chemotherapy drugs target rapidly dividing cells to combat cancer. This action can also affect healthy, fast-dividing cells, including those in the bone marrow responsible for producing blood components.
A primary reason for nosebleeds during chemotherapy is a reduction in platelet count, a condition known as thrombocytopenia. Platelets are tiny blood cells essential for blood clotting. When chemotherapy suppresses bone marrow function, the production of platelets decreases, making the blood less able to clot. Even minor irritation can lead to prolonged bleeding when platelet levels are low.
Chemotherapy can also affect the delicate lining of the nasal passages, known as the mucous membranes. These membranes can become weakened, dried out, or inflamed, making the blood vessels within them more fragile and prone to rupture. The loss of protective nasal hair, a side effect similar to hair loss on the scalp, further exposes these membranes to dryness and irritation. Some chemotherapy drugs can directly damage the lining of blood vessels, making them more susceptible to breaking or leaking. Other factors, such as dehydration or certain medications taken concurrently, can also contribute to nosebleeds.
Managing Nosebleeds During Chemotherapy
When a nosebleed occurs during chemotherapy, several steps can help manage it. Sit up and lean slightly forward to prevent blood from flowing down the throat, which can cause nausea or choking. Pinch the soft part of the nose, just below the bony bridge, firmly using your thumb and index finger.
Maintain continuous pressure for 10 to 15 minutes without releasing. Breathe through your mouth during this time. Applying a cold compress or ice pack to the bridge of the nose can also help constrict blood vessels and reduce bleeding. After bleeding stops, avoid forceful nose blowing, picking at scabs, or strenuous activities for several hours to prevent re-bleeding.
Preventative measures can reduce nosebleed frequency. Keep nasal passages moist using saline nasal sprays or drops, or by running a humidifier, especially in dry environments. Gently applying petroleum jelly just inside the nostrils can help maintain moisture. Avoiding irritants like smoke and aggressive nose blowing further protects the fragile nasal lining.
When to Seek Medical Attention
While many nosebleeds during chemotherapy are manageable at home, certain signs indicate the need for medical evaluation. Contact your healthcare provider if a nosebleed does not stop after 20 to 30 minutes of continuous direct pressure. This prolonged bleeding could signal a more significant clotting issue.
Seek immediate medical attention if bleeding is heavy or affects your breathing. Signs of significant blood loss, such as weakness, dizziness, or lightheadedness, warrant evaluation. Frequent or recurrent nosebleeds that are becoming more common or severe should also be discussed with your healthcare team. Report any other unusual bleeding or bruising, such as bleeding gums, blood in urine or stool, or tiny red or purple spots on the skin, as these may indicate a severely low platelet count or a broader clotting problem.