April 26, 2013 12:17:07 PM WATime
Hi Fotofairy, - thanks for posting your query.
Yes, chemotherapy may cause nosebleeds and increase risk of bruising and bleeding generally. Some people also experience dizziness. This may occur due to the action of chemotherapy on fast-growing cells in your body.
Chemo works against cancer cells by damaging them during cell division, therefore aiming to destroy any remaining cells. Unfortunately other fast-growing cells in the body are also damaged – e.g. hair, nails, mucous membranes and blood cells.
White blood cells are important for fighting infection – and most people are well aware they will have increased risk of infections during chemo. Other blood cells may be affected, including red blood cells (the oxygen-carrying cells in the blood) – if low may cause tiredness, dizziness and weakness; and platelets (clotting factors in blood) – if low may cause increased bleeding tendency.
Every person is individual – with differing effects on blood counts during chemo. Some people will not experience a significant drop in their blood counts and therefore are not likely to experience significant side-effects relating to this. For others the effects may be profound and have serious consequences, where medical intervention is required and possible treatment with transfusion or other appropriate treatments. For most people the effects are in-between (i.e. mild to moderate).
The blood vessels in the nose are very small and close to the surface, and if the mucous membranes inside the nose are also slightly damaged from the chemo, it is very easy for the damaged membranes to bleed with even the slightest trauma (blowing nose, rubbing nose). Sometimes nosebleeds occur with no obvious ‘trigger’ (spontaneous nosebleed). First-aid measures should be used as possible disrupted clotting factors may then cause a prolonged bleed. Good advice for managing a nosebleed can be found at: http://promotinghealthandpatienteducation.blogspot.com.au/2009/06/bloody-nose-stop-nosebleed-and-prevent.html
NB: Of course, similar first-aid measures are important for any bleed event during chemo, i.e. applying pressure, ice packs, seeking medical assistance if needed.
Blood tests are done prior to each dose of chemo in order to check your blood counts (including white cells, red cells and platelets). If the counts are too low, the chemo dosage may be adjusted, or the treatment may be delayed until counts improve. Other appropriate treatments may be needed to improve counts (e.g. injections, transfusions).
Nosebleeds may stop occurring if adjustments are made Fotofairy, however some people are more susceptible to nose bleeds (even without chemo!), therefore may continue to experience them.
The most important measures to take are to treat each nosebleed quickly to ensure a prolonged bleed doesn’t occur, and to discuss any events with your treating team.
Dizziness may relate to a number of factors involved with chemo – this is also very important to discuss with your team.
A great source of info on TAC chemo is available here: http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Combinationregimen/TAC.aspx
Hoping for the best Fotofairy. Would love to hear how you go, and please don’t hesitate to ask anything you like or post comments.
Love Glenys (Click Breast Care Nurse) xxx
The Click Breast Care Nurse 
