Living with cancer

Bruising or bleeding

Platelets are made by the bone marrow and they help blood to clot. If your platelet count is abnormal it can lead to abnormal bruising and blood clotting problems. Some types of cancer treatments, especially high dose chemotherapy, can cause platelet counts to drop.

Platelets in the blood are measured as part of a full blood count (FBC) test. The normal range is 150-400 million platelets per millilitre of blood (your healthcare team may abbreviate this to 150-400).

What are the symptoms of a low platelet count?

Symptoms of a low platelet count include nosebleeds, bleeding gums, unusually heavy periods, bruising and tiny blood spots on the skin (known as petechiae), or rashes (known as purpura). You should contact your healthcare team promptly if you notice any of theses symptoms.

How is a low platelet count treated?

Platelet transfusions can be used to prevent platelet counts form becoming too low. This means that serious problems with bruising or bleeding due to low platelets are uncommon. Your healthcare team will check your platelet count regularly and will recommend a platelet transfusion if you are considered to be at risk of bruising or bleeding.

Platelet growth factors have been investigated as a way of reducing problems associated with low platelet counts however they do not work well for the doses of chemotherapy most likely to increase the risk of bruising or bleeding (high dose chemotherapy) and re not routinely used.

Serious problems related to low platelet counts are not common but need immediate treatment when they do occur. You can be an active partner by asking you healthcare team if your treatment is likely to affect your platelet count and contacting them promptly if you notice any signs of abnormal bruising or any bleeding.

Things to do

  • Report any abnormal bruising or any bleeding immediately.
  • Use a soft toothbrush to clean your teeth.
  • Clean your nose by blowing gently into a soft tissue.
  • Wear padded gloves when using the oven.

Things to avoid

  • Taking any medicines, especially those containing aspirin or ibuprofen, unless you check first with your healthcare team.
  • Alcoholic beverages.
  • Cutting or nicking yourself when using scissors, knives, tools.
  • Burning yourself while ironing or cooking.
  • Contact sports.