Brenda Spriggs, MD, MPH, MBA
Epistaxis, or a nosebleed, is a common disorder that involves bleeding from the nostrils or, rarely, from the eye. Nosebleeds can result from bleeding at the anterior portion of the nose, or at the posterior, deeper parts of the nose. Although nosebleeds alone are not typically harmful, persistent or severe nosebleeds may indicate an underlying disease. Several forms of cancer have been linked to regular and severe nosebleeds.
One cause of regular nosebleeds is cancer of the nasal cavity or sinuses. The nasal cavity is made up of cartilage and bone, blood vessels and connective tissue, as well as an overlying epithelial skin cell layer. Any of these cell types can develop genetic mutations and divide to form a tumor, which can lead to bleeding from the nose.
Cedars-Sinai reports that nosebleeds are an early symptom of nasal or sinus cancer. Nosebleeds due to these cancers typically involve bleeding from one nostril. Patients with nasal cancers may also experience a blocked or runny nose on one side, and development of visual disturbances and headaches as the cancer progresses.
Nosebleeds may also be a symptom of leukemia. Leukemia is a group of blood cancers that affect white blood cells. A very common form of leukemia is chronic lymphocytic leukemia (CLL). CLL involves white blood cells in the bone marrow, as well as circulating white blood cells in the blood, and development of CLL can lead to nosebleeds.
The University of California, San Diego reports that nosebleeds caused by CLL are frequent and very severe. Patients with CLL may also experience other bleeding disorders like bleeding gums and excessive bruising. Other symptoms of CLL include nausea, weight loss, enlarged lymph nodes and frequent infections.
Another form of cancer, called Hodgkin's lymphoma, can also cause nosebleeds. Hodgkin's lymphoma is a cancer originating from the lymph nodes that leads to enlarged lymph nodes throughout the body. Often, the most noticeable enlarged lymph nodes are in the neck, armpit and groin areas. Hodgkin's lymphoma develops from abnormal white blood cells that accumulate in the lymph nodes, although some patients also have cancerous cells in their bone marrow.
Hodgkin's lymphoma leads to excessive and heavy nosebleeds, according to Macmillan Cancer Support. Patients with Hodgkin's lymphoma often experience other bleeding disorders, such as heavy menstrual periods in women or small pools of blood under the skin. Patients may also experience tiredness, weight loss and night sweats.