Cancer Treatment and Anemia: What You Need To Know

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Cancer makes you tired—physically, mentally, and emotionally. Anemia, a condition where the body has a low red blood cell count, can make you feel exhausted and irritable. Having both cancer and anemia together can completely knock the wind out of you.

Unfortunately, anemia is common in cancer patients. Between 32% and 49% of patients are anemic at the time of their diagnosis, and about 50% of patients will become anemic at some point during their treatment. Anemia does not cause cancer, but cancer treatments, and sometimes cancer itself, can cause anemia. Here’s what you should know…

What is anemia?

Anemia occurs when a person has below normal levels of red blood cells because their body isn’t making enough of them, they are losing blood too quickly, or their body is destroying red blood cells.

Red blood cells carry hemoglobin, an iron protein that carries oxygen to the rest of your cells. When your red blood cell count, or hemoglobin, is low, the cells can’t get sufficient oxygen to function at their best. This is why your hemoglobin levels are always checked before you are able to give blood—blood banks want blood that is at optimal oxygen-carrying capacity.

Signs and Symptoms

Anemia’s most recognized symptoms are fatigue and weakness, but it can also cause a rapid or irregular heartbeat, chest pain, shortness of breath, dizziness, pale skin, difficulty concentrating, headaches, and difficulty staying warm.

What causes anemia?

Anemia can be caused by several things unrelated to cancer or cancer treatment. Diet-related iron deficiency is a common cause. It can also be caused by blood loss, vitamin or mineral deficiency, organ problems, kidney disease, sickle cell disease, insufficient red blood cell production or red blood cell destruction, or a combination of these factors.

Cancer-related Anemia Causes

Cancer patients often experience anemia as a side effect of their treatment. Red blood cells are produced in your bone marrow, and chemotherapy damages bone marrow. Damaged bone marrow will not be able to produce red blood cells at normal levels. During chemotherapy, your ability to create red blood cells will be monitored by your medical team, and your ability to produce red blood cells will likely return to normal after chemo is complete.

Certain types of radiation therapy can also damage bone marrow and therefore your red blood cell count. Damage is more likely if you receive radiation targeted to your bones or to large areas of your body. Talk to your doctor to understand how radiation will affect you.

Finally, cancer itself may cause damage to your bone marrow. Cancers like leukemia, lymphoma, and multiple myeloma damage bone marrow, and other cancers that spread to the bones may crowd out healthy red blood cells.

Also, it’s worth mentioning that cancer all by itself is draining, with or without anemia. If treatment does cause anemia, simple tasks become that much harder. It’s best to prioritize rest and recovery!

What Should I Do If I have Anemia?

If you think you may have anemia, talking to your doctor should be your first step. Here are some questions that can help guide that conversation:

  • What is causing my anemia?
  • At what point should I call you?
  • Are there things I can do to feel better?
  • Would other treatments be helpful for me?

Your doctor may want to do a blood test to determine your red blood cell count. If it’s determined that your anemia calls for medical intervention, there are a few treatments your care team may prescribe:

  • Blood transfusion to increase your red blood cell count
  • Medications that tell the bone marrow to make more red blood cells
  • Vitamin or mineral supplements

You may also want to try eating foods high in iron and folic acid to help increase your hemoglobin count. Here are some some great options for increasing iron and folic acid in your diet:

  • Red Meat (if your diet allows for it)
  • Beans
  • Dried Apricots
  • Almonds
  • Broccoli
  • Enriched Breads And Cereals
  • Spinach
  • Asparagus
  • Lima Beans

Simple Fatigue-Fighting Strategies

Taking good care of yourself should be a priority at all times, but especially during cancer treatment. Remember these basics for fighting fatigue with or without anemia:

  • Enlist Supporters. If you have or have had cancer, people may have asked how they can help. Give them a job! Allowing others to help will be good for you and for them. Ask people for help with things like taking you to the doctor, making meals, doing the laundry, or picking up groceries.
  • Rest, But Also Move! Taking little naps through the day can be helpful (and so nice!), but too much time in bed can leave you feeling lethargic. Brief exercise bouts, such as short walks, can help invigorate you. Plus, a change of scenery can break up monotony.
  • Stay Hydrated. Make sure your body has all the help you can give it by drinking plenty of water.

A good rule to live by is to take one day at a time. Extend to yourself the same grace and understanding that you would give to others, and look for little things to encourage you! Keep fighting, friends!

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Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.
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