Hi and welcome to HCM,thank you for your query.
This is very serious cancer and all agressive treatment must be considered including amputation
. chemo and radioth can be started but of course his red blood count must be stabilized first since chemo and radioth will cause more damage to bone marrow
and decrease in red blood count. He should do surgery first to find the location of bleeding and try to stop it.after it,further management can be planned.
Wish you good health. Regards.