You are trying to climb an easy flight of step that used to be a breeze. Now you are hanging on to the rail, experiencing shortness of breath and feeling like a you are running a marathon. You wake up and it seems like a heavy blanket is on top of you, and to move any part of your body is a major achievement. You go out with friends for lunch and suddenly excuse yourself. You drive home and climb into bed or on the couch to take a nap.
What is happening? One diagnosis can be anemia. American Cancer Society states the reason is your blood has too little hemoglobin (HGB) which is the part of the red blood cell (RCB) that carries oxygen to all the cells in your body. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/anemia.html
Some of the symptoms can include a fast heart beat, shortness of breath, trouble breathing, and dizziness, chest pain or swelling. Unusually pale skin is a huge red flag and my sharp oncologist can tell by looking at me if I am worse.
The most telling issue for me is the extreme tiredness. Anemia is so intertwined with cancer that every patient should know about it. Everyday Health cites that almost all patients receiving chemotherapy are mildly anemic and 80% develop a more serious problem. https://www.everydayhealth.com/anemia/anemia-cancer-link.aspx
So why does this impact us “lucky” cancer survivors? Possible blood loss from gastro intestinal, urinary tract, male genital, head and neck and vaginal cancers can be linked to anemia. Anemia can also be the result of the treatment of the cancer itself. Other culprits can be blood loss, low iron level, or problems with the blood cells being developed by the body. Other diseases such as sickle cell anemia can cause serious problems. If the cancer survivor has had certain chemo drugs called platinum based chemotherapy there is a risk of damaging the kidneys.
The reason for me is obvious since I have a cancer of the bone marrow. I have Myelodysplastic Syndrome, but Lymphoma, Leukemia and Myeloma also cause anemia because the marrow is not producing cells correctly.
I never knew how important the bone marrow is and why. Cancer.Net explains that the bone marrow is a soft tissue where the cells are made. A hormone called erythropoietin “tells” the body when to make the red cells which are housed in the kidney! So any damage to the bone marrow or kidneys can cause the anemia. Radiation and chemo therapy may also damage the bone marrow. Very Well explains that chemo attacks all rapidly growing cells not just the cancer so the red blood cells, white blood cells and platelets are affected. This is why sometimes chemo has to be delayed. www.https://www.verywellhealth.com/blood-cancer-and-anemia-2252418.
Diagnosis of anemia is done with blood work and bone marrow biopsies. Once the doctor has confirmed the anemia, the treatments may vary since the cause needs to be determined first. The focus is usually raising the hemoglobin level to 12 for woman and 15 for men.
Diet is very important, which is ironical. I don’t feel like cooking and I make it worse by not eating correctly sometimes. Some of the food is easily prepared like vegetables, dark greens, sweet potatoes, dried apricots and peaches, meat and fish. Bread, cereal and pasta can also help with fatigue.
If the HGM need to be raised quickly, a blood transfusion may be needed. Iron supplements and infusions can also help. Epoetin alfa (Epogen, Eprex, Procrit) or darbepoetin alfa (Aranesp) may be prescribed to stimulate the red cells much like the hormone in the body. One caution is that these medicines can cause blood clots easily, so if any sign of redness or swelling emerges, call the doctor or go to the Emergency Department immediately!
In summary, anemia is common with cancer. Do not ignore the symptoms. My doctor knows if I tell her I am unusually fatigued to draw blood right away. Treatments are out there and you can help with diet. For me personally, light exercise also helps me to feel better and get moving.
As for the fatigue, sometimes you just need to tell your friends and family what is happening. I was at a church function with people I love last week. I started fading fast and explained what was happening. They told me to go ahead and go home. I climbed into bed right away and a nap does wonders. My article “Cancer survivors and the art of napping” is the best solution I have. Nap away and carry on!