When there are not enough red blood cells to carry oxygen to body tissues, you can feel tired, weak, or dizzy. You may have shortness of breath, feel cold, be pale, or have a rapid heartbeat. Sometimes anemia leads to ringing in the ears.
Anemia can be a result of:
- Bleeding somewhere in the body. Sometimes large polyps or cancers bleed into the intestinal tract causing anemia, which may be a sign of colorectal cancer.
- Cancer itself.
- Chemotherapy or radiation treatment.
Medical management of chemotherapy-induced anemia
Your doctor will measure your hemoglobin (hgb) to determine if you are anemic. Hemoglobin is measured in grams per deciliter (g/dL). Mild anemia is considered 10 to 11 g/dL, moderate anemia 8 to 10 g/dL. If your hemoglobin falls below eight, it is severe and you may need a blood transfusion.
To prevent the need for a blood transfusion, you may receive injections of an erythropoiesis-stimulating agent or ESA such as Procrit®, Epogen®, or Aranesp®. These drugs can have serious side effects and, in some cases, have been shown to reduce response to cancer treatment. The FDA has changed labeling for ESA drugs to reflect the need to use these drugs very carefully. If your doctor recommends using an ESA to manage your anemia, discuss the risks and benefits thoughtfully before making your decision. Specifically;
- The goal of using an ESA is to reduce the risk of needing a blood transfusion, but you may still need one even if you take an ESA.
- You should not take an ESA to treat cancer anemia if you are not on chemotherapy. (On the FDA approved label)
- There is no evidence that an ESA will make you feel better or improve your quality of life.
- Ask that the lowest dose possible be used to slowly raise hemoglobin levels. (On the FDA approved label)
- Stop ESAs when you stop chemotherapy.
In combination with ESA treatment, your doctor may also prescribe intravenous iron.
Coping with anemia
If you are anemic, you may be more tired and unsteady. Take care of yourself by:
- Resting during the day.
- Getting a good night’s sleep.
- Getting up slowly after sitting or lying down to avoid dizziness.
- Asking for and accepting help from other people with daily tasks.
- Planning your activities with short rests and when you feel strongest.
- Drinking extra fluids and eating well.
Where Can You Go for More Information
Cancer.Net covers anemia in its ASCO-physician approved patient materials.
Cancer.Net also has the ASCO Patient Guide: Epoetin and Darbepoetin Treatment, which includes links to the 2007 FDA Public Health Advisory on the use of erythropoiesis-stimulating agents.
FDA Information on Information on Erythropoiesis Stimulating Agents (ESA) (marketed as Procrit, Epogen, and Aranesp) has links to labels, label changes, information for patients, and the history of the issues involved with these drugs.