Anemia

Anemia is defined as lowering of red blood cells and disruption of their most important function -- carrying oxygen. In cancer patients, it may be mild to severe and may be attributable to a variety of causes. Severity of anemia may increase as the disease progresses.

Causes:

Reduced production of blood from bone marrow, which is normally due to suppression of bone marrow by the cancer. Some cancers produce substances with a direct negative impact on the bone marrow; other cancers can spread and occupy the bone marrow space and interfere with blood production. In most instances, treatment of cancer also harms the bone marrow. Chemotherapy and Radiation therapy may both cause anemia.

Bleeding may occur in cancer patients and result in anemia. Blood loss could be directly from the cancer site, as in colon cancer where bleeding occurs inside the large bowel. It may also be due to other causes. Cancer treatment can cause lowering of platelets which can make patients prone to bleeding. Most common sites for this kind of bleeding are the stomach and bowels, under the skin, gums, in the urine, etc.

Damage and destruction of the red blood cells can cause anemia. This condition, which is referred to as Hemolysis, can be seen in a variety of cancers -- stomach, prostate, colon, pancreas, etc. Certain chemotherapy drugs (Mitomycin, Velban) and severe infections (DIC) can also cause Hemolysis.

Signs and Symptoms:

Signs of anemia are to some extent due to the underlying cancer. Certain signs, however, can be attributed to reduction in the ability of blood to carry oxygen. These are: fatigue, weakness, loss of energy, paleness, shortness of breath, low blood pressure. In severe cases, patients may become dizzy while trying to stand up, or they may even pass out.

Treatment of Anemia:

Treatment of anemia depends on several factors such as:

• Cause of anemia

• Severity of anemia

• Patient's overall condition

If it is mild, anemia may be left untreated. In moderate cases, especially if the patient is tolerating it well, bone marrow could be stimulated to produce more blood. This is normally accomplished by using Procrit. Blood transfusion is a last resort and is used in patients with severe anemia. Other contributing factors to anemia have to be identified and treated.