Chemotherapy can affect the ability of the bone marrow to make platelets. Platelet cells are the type of blood cells that help form blood clots and help stop bleeding. If your blood does not have enough platelets, you may bleed or bruise more easily, even without having an injury. Having a low platelet count is called thrombocytopenia. Thrombocytopenia is a less common side effect of chemotherapy.

Thrombocytopenia is a less common side effect of chemotherapy but may occur ten to twenty-one days after chemotherapy treatment. However, if you notice bleeding at any time, it is important to let your healthcare team know about it immediately.

Tell your healthcare team if you notice any of the following signs:

• unexpected bruising
• prolonged bleeding from minor cuts or scratches
• small red spots under the skin
• reddish or pinkish urine
• black or bloody bowel movements
• any bleeding from your gums or nose
• bad headaches
• dizziness
• an increase in weakness
• pain in joints and muscles

Your healthcare team will check your blood counts regularly. Low platelet counts can be managed, with care. Your healthcare team will monitor your signs and give you advice on taking precautions to avoid injury. If your platelet counts are extremely low, your doctor may recommend a platelet transfusion or drugs that boost your platelet production.

What you can do

• Avoid activities that might result in injury.
• Use an electric razor for shaving.
• Brush with a soft-bristle toothbrush.
• Avoid other medications* that may weaken platelets. These include:
• Acetylsalicyclic-acid (Aspirin®) and products that contain acetylsalicyclic-acid
• Ibuprofen (Advil®, Motrin®) and other non steroidal anti-inflammatory drugs (NSAIDs)
• Warfarin (Coumadin®)
• Some herbal products

*Note: You should talk to your doctor, pharmacist or nurse before starting or stopping any medication while you are under treatment for cancer.

Aspirin® is a registered trademark of Bayer Inc.
Advil® is a registered trademark of Wyeth Consumer Healthcare Inc.
Motrin™ is a registered trademark of McNeil Consumer Healthcare.
Coumadin® is a registered trademark of Bristol-Myers Squibb Canada.

Everyone's experience of side effects is different, and different side effects will occur at different times of the treatment. Find out when you can expect side effects.