Treatment Side Effects - Bruising and Bleeding

Reviewed by: HU Medical Review Board | Last reviewed: January 2017.

Some treatments for lung cancer can lower the platelets in the blood, which increases the risk of bruising or bleeding. Platelets are the blood cells that are responsible for clotting, and when platelet counts are lowered, the body bleeds and bruises more easily. Lowered platelet count is also known as thrombocytopenia.

What is thrombocytopenia?

Thrombocytopenia can be mild or can become serious. The condition can also impact cancer treatment, causing a delay or stop to some treatments. In addition to the physical effects, thrombocytopenia can be distressing for patients, increasing their fear and anxiety about their health.1,2

A higher risk for bruising or bleeding easily

Lung cancer treatments that can increase the risk of bruising or bleeding easily include chemotherapy, targeted therapy, and radiation therapy. Chemotherapy or targeted therapy agents each have their own set of potential side effects or complications, and patients should discuss with their doctor the potential risks of the specific treatment they are receiving. The incidence and severity of thrombocytopenia are different for each medication, and the side effect may be short-lived. In addition, not everyone experiences the same side effects with a particular treatment. Most side effects, such as thrombocytopenia, tend to go away when treatment is finished.1,2

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In addition to treatments increasing the risk of bleeding or bruising, lung cancer that has spread (metastasized) to the bone marrow can also create thrombocytopenia. Some viruses have also been shown to affect platelets, potentially causing thrombocytopenia.2

When to seek medical attention

Patients who are undergoing treatment for lung cancer should contact their health care provider if they experience any of the following:1

  • Bleeding that doesn’t stop after a few minutes
  • Urine that is red or pink
  • Stool that is black or bloody
  • Menstruation that is heavier or lasts longer than normal
  • Bad headaches
  • Confusion
  • Changes in vision

Reducing the risk of bruising or bleeding easily

The risk of bruising or bleeding can be reduced by taking extra care, such as:

  • Brushing with a soft toothbrush
  • Wearing shoes, even indoors, to protect feet
  • Using an electric shaver rather than a razor
  • Using lotion and lip balm to prevent dryness
  • Avoiding medications like aspirin or ibuprofen that can increase the risk of bleeding
  • Avoiding alcohol
  • Promptly taking action to stop bleeding of any cuts
  • Using ice on areas of bruising 1

Managing thrombocytopenia

Thrombocytopenia from lung cancer treatment is often short-lived. Patients who experience thrombocytopenia may be given a platelet transfusion to increase their platelet count and reduce bruising and bleeding. Most patients respond well to platelet transfusion. Some patients may experience a reduction in dosage of or delay in their chemotherapy regimen, allowing the body a chance to recover its platelet counts.2

There are medications that can treat thrombocytopenia, called thrombopoietin receptor agonists. However, few studies have been completed to demonstrate their ability to treat thrombocytopenia caused by chemotherapy in cancer patients. Reduction of chemotherapy dose and administration of platelet transfusions are the main treatments for thrombocytopenia in lung cancer patients.2