Does chemotherapy cause anaemia? Why is anaemia common among cancer patients?
Anaemia is a condition that involves having a low level of red blood cells and in that case, the blood lacks enough haemoglobin. Haemoglobin is the part of the red blood cell that carries oxygen to body cells and therefore, when there is not enough haemoglobin in the blood, little oxygen can be carried throughout the body causing fatigue, dizziness, shortness of breath and pale skin, among other symptoms.
Relationship between Cancer and anaemia
Approximately 30% of cancer patients have anaemia and there are several reasons why this can happen. When it comes to cancer, the cancer itself or its treatment or both factors can be the cause of anaemia in people with cancer.
Anaemia can be caused by the:
- Inability to produce red blood cells,
- Loss of red blood cells, or
- Destruction of the red blood cells.
Different types of cancers and how they can lead to anaemia.
- The first type of cancers which may be quite expected to lead to anaemia are cancers that affect the bone marrow. These include leukaemia and lymphomas, which compete with the bone marrow’s function and so interfere with the production of red blood cells.
- The other types of cancers that can lead to anaemia are those that metastasize to the bone marrow. These include prostate and breast cancers.
- Cancers that affect the gastrointestinal (GI) tract system such as stomach and colon cancers cause frequent bleeding which can lead to anaemia.
How Cancer Treatment is linked to Anaemia
There are various treatment options for cancer and one common one is chemotherapy which involves administering anticancer drugs to kill cancer cells. However, since the chemotherapy agents are non-specific, this treatment, in the process, attacks other cells in the body such as those that line the GI tract and hair follicles as well as blood cells.
This is, however, not the case in every cancer patient. Not every cancer patient will get anaemia and having anaemia does not necessarily mean you have or will develop cancer. Cancer is, in fact, not a common cause of anaemia. Malaria, parasites such as hookworm and inherited conditions like thalassemia or sickle cell, on the other hand, are major causes.
Treating Cancer and Chemotherapy-induced Anaemia
Taking medication such as iron pills and eating foods rich in iron such as red meat, and green leafy vegetables like spinach, may not be effective in treating cancer-induced anaemia unless the anaemia is brought about by frequent bleeding.
Blood transfusions, for a significant period of time, were considered the ideal treatment for anaemia, including cancer-induced anaemia. Currently, treatment can be done using crystalloid and hematinic treatment, epoetin alfa administration, red blood cell (RBC) transfusion or a combination of these options.
RBC transfusion is done for cancer patients who have acute anaemia due to blood loss when crystalloid infusions are not effective in the treatment. A crystalloid infusion or fluid is a solution of sodium chloride which is close to the blood’s concentration.
Epoetin alfa is the human recombinant of erythropoietin used in treating anaemia in cancer patients. It regulates the rapid growth, maturation and differentiation of RBCs (red blood cells).