Anemia (low Red Blood Cell Count)

You may think that feeling tired is just part of having cancer. However, your fatigue may be due, in part, to having anemia.

Anemia is a common side effect of chemotherapy. Chemotherapy can affect the ability of bone marrow to produce red blood cells. Red blood cells carry oxygen to all parts of your body. When you do not have enough red blood cells, your body does not get enough oxygen to do its job properly. Having too few red blood cells is called anemia. Anemia can make you feel unusually tired, extremely fatigued, dizzy or short of breath. Talk to your healthcare team if you notice any of these symptoms.

Your healthcare team will check to see if you have anemia every time you get a blood test. If your red blood cell counts are too low, they may recommend treatment.

Some of the treatment options for anemia caused by cancer or chemotherapy are:

1. medications that boost red blood cell production
2. red blood cell replacement (transfusion)
3. consuming a diet high in nutrient-rich foods

To prevent or treat anemia your doctor may prescribe a medication that will help increase the number of red blood cells produced by your body. These medications are called erythropoiesis-stimulating agents. Erythropoiesis-stimulating agents stimulate your bone marrow to make more red blood cells.

As with any medication, erythropoiesis-stimulating agents are not right for everyone. Some people treated with erythropoiesis-stimulating agents have experienced infections, fevers, headaches, muscle soreness, nausea or chest pain. If you currently have, or have ever had high blood pressure, heart disease (e.g. angina) or epileptic seizures, erythropoiesis-stimulating agents may not be right for you. People who have uncontrolled high blood pressure, certain allergies or a tendency to develop antibodies should not take erythropoiesis-stimulating agents.

Before taking medications for anemia, you should also let your doctor know if you are pregnant, planning to become pregnant or are breast-feeding. Patients with cancer may have an increased risk of blood clots in the veins or the lungs. The potential effect of erythropoiesis-stimulating agents on tumour progression is not known.

If your red blood cell counts are very low, your doctor may suggest a blood transfusion. This is the fastest way to increase your red blood cells. However, the increased level of blood cells may not last very long especially if you are still undergoing chemotherapy. You may need more than one transfusion.

Your healthcare team will watch your red blood cell counts closely and determine which treatment, if any, is appropriate to treat or manage your anemia if it develops. With time, your blood cell count may recover on its own. The symptoms of anemia often lessen gradually once your chemotherapy treatment is completed. However, this may take several weeks or months.

What you can do:

• Get plenty of rest. Sleep more at night. Take naps during the day, but don't let them interfere with your night time sleep.
• Limit your activities. Do only the things that are necessary or most important to you.
• Keep the things you use often within easy reach.
• Eat a well-balanced diet. Follow the instructions of your doctor and nurse for a well-balanced diet—with lots of fluids and, if recommended, nutritional supplements.
• After sitting or lying down, rise slowly to prevent dizziness.
• Breathe with your lips pursed if you get short of breath.
• Ask family and friends for help with daily activities such as shopping, driving, child care and other responsibilities.

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