Sunday, November 4, 2007

Understanding the Relationship Between Anemia and Cancer

Anemia, a common side effect of cancer treatment, is a condition in which there are fewer red blood cells than normal. The function of red blood cells is to transport oxygen to the tissues of the body. Without an adequate number of red blood cells, the body’s need for oxygen cannot be effectively met. Common symptoms of anemia include severe fatigue, shortness of breath, diminished activity level, reduced overall feeling of well-being, and possible mental dysfunction. Anemia may also exacerbate existing medical conditions. For example, the heart has to work harder in an anemic patient, which may aggravate a heart condition. Furthermore, severe anemia may cause a treatment delay or dose reduction, as well as reduce the effectiveness of some chemotherapy agents and radiation, thus jeopardizing the possibility of the best long-term results from treatment. Fortunately, there are treatments available to improve anemia and its symptoms.
Anemia in cancer patients may occur either as a direct result of the cancer or as a side effect of cancer treatment. Chemotherapy, radiation therapy, and blood loss during surgery are all common causes of anemia in cancer patients. Over 60% of patients treated with chemotherapy develop anemia. This is because chemotherapeutic agents kill rapidly dividing cells in the body, including cancer cells, as well as several types of normal cells like red blood cells.
Early detection and prompt treatment of anemia is the best strategy for preventing severe anemia from occurring and ensuring that when anemia does occurs, the duration is limited. Although healthcare providers try to monitor for anemia, patient observations are an important source of information on warning signs and they should notify their doctor or nurse if they are feeling abnormally fatigued.
The treatments available for chemotherapy-induced anemia in cancer patients are Procrit® and Aranesp®. These agents are FDA approved and have been safely used in cancer patients. They contain a synthetic erythropoietin, which stimulates the production and maturation of red blood cells, ultimately increasing red blood cell levels enough to correct anemia. Procrit® is approved to be given 3 times per week, while Aranesp® is approved for administration only once every 2 weeks. Every 2 week administration has the added advantage of reducing the burden of frequent doctor visits for patients and their caregivers.
Although most patients develop anemia as a direct consequence of chemotherapy, diet may also play a role in reducing the severity or duration of anemia in some patients. Iron, folic acid, amino acids, and vitamins B6, B12, and C are all important components to the development and maturation of red blood cells. Green leafy vegetables, eggs, fruit, legumes, grains, and meats should be included in the diet of a person that is diagnosed with cancer, or one that has already developed anemia. Additionally, patients should ask their physicians if supplementation is necessary to manage their anemia.
Although anemia can pose serious consequences, early identification and subsequent intervention with effective treatments such as Procrit® and Aranesp® may help to correct anemia, thereby improving patients’ quality of life and making it possible for them to receive optimal therapy.

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