Anemia occurs when a patient has a low red blood cell (RBC) count. When you don’t have enough healthy red blood cells it means that your blood has lower than normal hemoglobin (Hgb) levels. Without enough hemoglobin, red blood cells have a difficult time carrying oxygen from the lungs throughout your body to help it work properly, forcing your body to work harder in order to compensate. The end result is that your body will show signs of being very tired.
Because many cancer patients receive treatments that affect the blood cells, anemia is a common side effect. Normal hemoglobin levels for women are usually in the range of 12.0 to 15.5 gm/dL; for men, the normal level is from 13.5 to 17.5 gm/dL.
While receiving chemotherapy or radiation therapy, your hemoglobin level may drop to lower than these normal levels. Part of your regular follow ups during treatment is a blood test to check hemoglobin levels as well as other types of cells in the blood. If your hemoglobin level drops below 12.0 gm/dL, you are considered to be anemic. For most patients, this is a treatable condition.
Symptoms of Anemia
Symptoms may not present themselves right away. When they do, however, you may experience:
Weakness or fatigue
Dizziness or lightheadedness
Chest pain or rapid heartbeat
Shortness of breath or difficulty breathing
Swelling in the hands or feet
Pale or yellowish skin
While none of these symptoms should be ignored, it is especially important that you alert your team at Affiliated Oncologists immediately if you are experiencing any of the first four symptoms listed above.
Talking With Your Cancer Care Team About Anemia
If your oncologist notes that your hemoglobin levels are low, here are some questions that you may want to ask?
What is causing the anemia?
Do I need to have my treatment dosages or schedule changed because of it?
Which problems should I call you about?
Should I see a dietitian to decide about supplements and diet changes?
How to Manage Cancer-Related Anemia
Since red blood cells are destroyed as a side effect of chemotherapy and radiation therapy, there is nothing specifically that you can do to prevent anemia from occurring. Instead, your focus should be on preventing your body from becoming extremely tired. Failure to do so may result in your becoming exceptionally weak. Here are some steps you can take if you have fatigue caused by anemia:
Save your energy and ask for help. Choose the most important things to do each day. When people offer to help, let them do so. They can take you to the doctor, make meals, or do other things you are too tired to do.
Balance rest with activity. Take short naps during the day, but keep in mind that too much bed rest can make you feel weak. You may feel better if you take short walks or exercise a little every day.
Eat and drink well. Talk with your doctor, nurse, or a registered dietitian to learn what foods and drinks are best for you. You may need to eat foods that are high in protein or iron.
Medical Treatment for Anemia
There are several ways that anemia can be treated medically. Depending on the severity of the anemia, your oncologist may start with a supplement of over-the-counter iron pills on a daily basis.
Your oncologist may recommend injections of a "growth factor" (Aranesp or Procrit), which work by stimulating the body's production of erythropoietin. An important growth factor used with cancer patients stimulates the growth of red blood cells. The more red blood cells your body produces, the greater the chance your risk of becoming anemic will decrease. Additionally, it may also decrease the number of blood transfusions that may be required during your treatment.
If hemoglobin levels continue to drop, there may need to be a blood transfusion to get your red blood cell count back to a healthier level.
Your Affiliated Oncologists cancer care team will help you through the steps of managing cancer-related anemia. Just be sure to give your body the rest and good nutrition it needs to rebuild your red blood cell count.