Anemia: Be Aware of This Cancer-Related Risk

• Cancer and its treatments can cause a variety of side effects, and one that you might not know about is anemia. But if you develop this condition, treating it can make you feel better almost immediately—and help you get back to effectively fighting your cancer.

  What Are the Symptoms of Anemia?

  Anemia happens when you either don’t have enough healthy red blood cells or the cells you have don’t function properly.

  Red blood cells carry hemoglobin, an iron-rich protein that transports oxygen around your body.

  Anemia may start slowly. So you might not notice symptoms at first. But as your hemoglobin levels drop, you may experience one or more of these signs and symptoms:

  • Fast or irregular heartbeat
  • Shortness of breath
  • Dizziness
  • Headache or pounding in the ears
  • Chest pain
  • Swelling of hands or feet, or both
  • Pale skin, nail beds, mouth and gums
  • Extreme tiredness

  Even with a variety of possible symptoms, identifying anemia can be tricky. And people who have cancer are often fatigued from the disease and its treatment. When in doubt, blood, fecal, or bone marrow tests can determine if you have anemia and help pinpoint what’s causing it.

  What Causes Anemia in Cancer Patients?

  People with cancer are vulnerable to anemia for many reasons, said Rashmi Khanal, MD, a hematologist-oncologist at Fox Chase Cancer Center.

  Cancer itself can cause bleeding that leads to anemia.

  Cancer treatments can also bring on anemia. “Most chemotherapy can contribute to it,” Khanal said.

  Nutrition plays an essential role. According to Khanal, tumors secrete cytokines leading to cancer related anorexia, which may contribute to nutritional deficiency and anemia henceforth.

  Also, the body does not utilize iron, folate, and vitamin B12 when contending with cancer.

  “And that can lead to deficiencies that make cancer patients more susceptible to anemia,” Khanal said. Examples of these deficiencies:

  • Cancer, especially GI cancers, can hinder the body absorbing nutrients from food
  • Cancer can infiltrate bone marrow – the blood cell factory – which can lead to a decrease in the production of red blood cells.
  • Cancer sometimes triggers an autoimmune response that destroys the body’s normal red blood cells.

  How is Anemia Treated?

  Once doctors have determined what’s causing someone to be anemic, the next step is to treat that underlying cause and to bring the patient’s hemoglobin level up enough that symptoms get better.

  Among the possible treatments for anemia:

  • Focusing on calorie rich diet by eating more iron-rich foods, such as dark green leafy vegetables, sweet potatoes, prunes and raisins, beans, meat, and fish. Consulting a nutritionist, like the ones at Fox Chase while receiving cancer treatment, can be helpful.
  • Getting a red blood cell transfusion. “Transfusion is a quick and easy fix, as long as your treatment team simultaneously look for the root cause of the anemia and continues to work on more comprehensive treatment plan of that cause,” Khanal said.
  • Taking oral or parenteral iron, vitamin B12 and/or folic acid supplements when needed.
  • Erythropoietin stimulating agents are available as an option as well.

  “Understanding the existence of anemia while patients are receiving cancer treatment is of utmost importance. A simple intervention can change how a person feels, and can make a big difference in a patient’s quality of life,” Khanal said.

  Because treatment can significantly improve your day-to-day life, be sure to tell your cancer care team if you have symptoms of anemia.

  Anemia Experts

  The hematology team at Fox Chase also treat people with anemia who don’t have cancer.

  “Bone marrow disease, anemia due to chronic kidney disease, and inflammatory diseases—such as lupus and rheumatoid arthritis—can all trigger anemia as well, as can certain medicines,” Khanal said.