Cancer Treatment   /   Chemotherapy

Low Red Blood Cell Count (Anemia)

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OncoLink
Last Modified: February 12, 2012

Anemia is a decrease in the number of red blood cells (RBCs). Since most cancer therapies destroy cells that grow at a fast rate, and red blood cells have relatively rapid growth rates, they are often affected. An important part of the RBC is hemoglobin, the protein that carries oxygen throughout your body. Therefore, when your hemoglobin is low, oxygen levels are decreased, and your body has to work harder in order to compensate. The end result is that your body becomes tired.

Normal hemoglobin levels for women are usually in the range of 12-16 gm/dL; for men, the normal level is from 14-18 gm/dL. While receiving cancer therapy, your hemoglobin level may drop to lower than these normal levels, so your hemoglobin level will be checked periodically throughout the course of treatments. Any time that your hemoglobin level drops below 10.0 gm/dL you are considered to be anemic.

The signs and symptoms of anemia include:

• Weakness or fatigue
• Dizziness
• Headache
• Shortness of breath or difficulty breathing
• Palpitations or rapid heart beat
• Pale skin
• Feeling cold, particularly in the hands and feet

What Can I Do to Prevent Anemia?

Since red blood cells are destroyed as a side effect of cancer therapy, there is nothing specifically that you can do to prevent anemia from occurring. Anemia may cause you to feel weak and tired. Here are some ways that may help you feel better:

Saving energy

• Get plenty of sleep.
• Avoid prolonged or strenuous activity.
• Pace yourself; take rest periods during activities that make you feel tired. Take short naps when needed.
• Prioritize your activities so you will have enough energy for important activities or the activities that you enjoy most.
• Ask friends and family to help you prepare meals or do chores when you're tired.

Avoiding injury

• Change positions slowly, especially when going from lying to standing to prevent dizziness.
• When getting out of bed, sit on the side of the bed for a few minutes before standing.

Eat a well-balanced diet

• Eat foods high in iron, including green leafy vegetables, liver and cooked red meats.
• Drink plenty of fluids.
• Avoid caffeine and big meals late in the day if you're having trouble sleeping at night.
• Take iron supplements only if you have been told to by your oncologist or nurse.

When Should I Call My Doctor?

Call your doctor immediately if you have any one or more of the following:

• Dizziness
• Shortness of breath or difficulty breathing
• Excessive weakness or fatigue
• Palpitations or chest pain

How is Anemia Treated?

Depending on the cause and severity of the anemia, there are several ways that anemia can be treated. Your doctor may instruct you to take over-the-counter iron pills on a daily basis or may order blood transfusions.

Your doctor may also choose to order injections of a "growth factor", which can be used to stimulate the growth of red blood cells, in certain patients. By increasing your body's production of red blood cells, this growth factor may decrease your risk of becoming anemic, and may also decrease the number of blood transfusions that may be required during your treatment.

Growth factors are administered by injection. You may receive the injections from the oncology nurse, or you and/or a family member may be taught how to give the injections at home. Once your red blood cell count has returned to a normal level, the injections will be stopped.

If necessary, your oncologist may decide to delay further treatments until your red blood cell count has returned to normal levels.