Anemia: More Than Just an Iron Deficiency

Defined as a “pathological deficiency in the quantity of oxygen-transporting hemoglobin in red blood cells”, anemia is a common problem for cancer victims because it can be caused by the therapies used to suppress or to control tumors. In the movies and in books, anemia is often misrepresented as solely an iron deficiency, but this is not accurate. Anemia presents itself in several different ways, and has several different causes.

The most common symptom of anemia is fatigue, which is a feeling of weakness or diminished physical or mental capacity that cannot be fixed by rest or sleep. It is often difficult to separate the symptoms of anemia from the symptoms of co-existing illnesses that can produce the same results. Patients might also experience headache, dizziness, chest pain, difficulty breathing, nausea, and an inability to complete normal daily activities.

The number one cause of anemia is acute blood loss, which might be the result of hemorrhaging, external injury, or of abnormal menstrual bleeding. Chronic illnesses are also a major cause of anemia – particularly malignancies, kidney disease and liver disease – because they contribute to the major causes of anemia. Cancer therapy can cause mild anemia, which might be worsened by the co-existing illness, and any disease that causes hemolysis, which is the breakdown and destruction of red blood cells. Cancer patients and patients with other pre-existing illnesses should have their red blood count checked on a regular basis and should pay close attention to the worsening or intensifying of common symptoms.

Other, less common causes of anemia are poor nutrition, bone marrow infiltration, inflammation or a decreased response to erythropoietin.

Successful treatment of anemia involves positively identifying the cause of the anemia and treating the cause rather than the anemia itself. For example, if the anemia is caused by blood loss, a transfusion might be necessary to restore health in the patient’s blood. There is no drug available that can rectify the damage that anemia causes; therefore, the pre-existing condition or injury must be treated instead.

The doctor will most likely order several laboratory tests as well as a physical examination of the patient. After anemia is positively identified as a problem, the physician will recommend the best course of action.

Depending on what the tests reveal, a number of actions may be taken to correct the problem. Although none of them work one hundred percent of the time, when a cause is pinpointed the condition can usually be corrected. The earlier a patient seeks medical treatment, the better the chance for defeating the anemia. In extreme cases, such as when a patient is already afflicted with a terminal illness, the anemia might only be contributing to mortality.

Common treatments of anemia include:

– Dietary supplements. Iron, folic acid and B12 are often needed.
– Change in treatment for co-existing illnesses (such as a dosage elevation)
– Erythropoietin
– Blood transfusions. Often, the patient seeks medical treatment too late for a blood transfusion to be effective. However, if the rest of the body’s systems are healthy, an infiltration of new red blood cells can completely reverse the effects of anemia.

Anemia should never be underestimated or ignored. Despite other conditions that might be contributing to the symptoms, anemia is a serious problem in and of itself, and should be treated as quickly as possible. Victims of traumatic wounds should be tested immediately for anemia, though the condition might present itself hours or even days after the initial injury.

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