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Cancer
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Anaemia
 
 
Anaemia: What is it and what causes it?

Anaemia is an extremely common consequence of cancer and its treatment. This means a reduction in the amount of haemoglobin in your circulating blood. Haemoglobin is contained in the red blood cells. Red blood cells are produced in the bone marrow, and have a life-span of around 100 days. Haemoglobin is an iron-containing protein that carries oxygen from the lungs to the tissues. The normal level is around 12-15 grams per 100 mls of blood. It is not uncommon for this level to fall to between 7 and 11 in patients undergoing cancer treatment.
There are many reasons for anaemia in people undergoing cancer treatment.
They include:

  • The cancer itself. Cancer cells sometimes secrete chemical substances which suppress the production of red blood cells in the bone marrow. Sometimes cancer cells may occupy the bone marrow itself, suppressing the production of red blood cells.

  • Blood loss. Sometimes the cancer and its treatment may cause subtle, and quite unnoticed, loss of blood in the motions, or perhaps heavy periods. Certain drugs, like aspirin, and anti-arthritis medications (like Naprosyn, or Voltarin) may cause irritation to the lining of the stomach causing unnoticed slow blood loss. Blood-thinning agents, like warfarin and clopidogrel (“Plavex”), may exacerbate blood loss. These drugs are contraindicated in patients having chemotherapy unless specifically prescribed by your oncologist.

  • Diet deficiency. Cancer and its treatment interfere with appetite, and a low intake of red meat and green vegetables may contribute to anaemia, although it is rarely the sole cause in cancer patients.

  • Surgery. Blood loss is an almost inevitable consequence of surgery.

  • Destruction of red cells in the body (haemolysis). This is a rare complication of cancer and its treatment.






Symptoms of anaemia.

The following list is not exhaustive, and remember that many of these symptoms are non-specific. They can be caused by many things. Symptoms like fatigue often have multiple cause in patients undergoing cancer treatment, and it is unusual that you an fix the problem just by fixing the anaemia, though it may help considerably.
The symptoms of anaemia include:

  • Fatigue.

  • Faintness and/or light-headedness

  • Dizzy spells, and sometimes collapse.

  • Pallor.

  • Palpitations, or rapid heart rate.

  • Chest pain, or angina.

  • Breathlessness (“dyspnoea”).

  • Nausea.




Treatment of Anaemia

Your doctor need to diagnose the cause and nature of the anemia before prescribing the appropriate treatment. DO NOT try to treat it yourself or with the aid of the local “naturopath.”
Treatments include:


  • Diet supplements of agents like iron, folic acid, and vitamin B12. Note thast these are not usually he problem in cancer patients. There is no pint taking kilograms of iron if your bone marrow is unable to make use of it! Listen to your doctor, not the lady next door!

  • Treatment of the cancer. This is often the most effective, but it takes time.

  • Avoid any drugs that cause blood loss in the gastrointestinal tract. These include aspirin, blood-thinning agents (like Warfarin), and anti-arthritis drugs, like Indocid, Naprosyn, Voltarin etc.

  • Erythropoeitin injections. These stimulate the bone marrow to produce more red cells. They are not readily available on the Pharmaceutical Benefits Scheme except in patients who have kidney failure. They are very expensive and only available on prescription from your oncologist.

  • Blood transfusion. This is the quickest and most effective treatment. Nowadays, blood transfusion is extremely safe.





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