Cancer

Understanding the Link Between Cancer Disease and Anaemia

anaemia in cancer

  • WHO defines anaemia as a haemoglobin concentration less than a specified cut-off point.
  • The cut-off point is determined by factors such as age, gender, physiological status, smoking habits, and altitude at which the population is evaluated.
  • Age, sex and race-specific nomograms are used.
  • Anaemia is classified as mild, moderate, severe and very severe depending on these references.
  • The prevalence of anaemia in cancer patients depends on the cut-off chosen for classifying anaemia.
  • Anaemia prevalence also varies with the type of malignancy.
  • It is more common in haematological malignancies (72%) than in solid tumours (66%).
  • Causes of anaemia in cancer can be:
    • Inadequate production of RBCs
    • Increased destruction of RBCs
    • Bleeding
  • Mechanisms of anaemia can be disease-related, therapy-related or concomitant factors.
  • Disease-related mechanism can be due to production of cytokines or other factors like bone marrow infiltration.
  • Treatment-related mechanisms can be due to chemotherapy, radiotherapy or other drugs. It can be transient or sustained.
  • The most common symptom of anaemia in cancer is fatigue.
  • Different studies have shown decreased survival with cancer disease with the presence of anaemia.
  • However, anaemia can also indicate advanced disease in haematological malignancies.
  • Anaemia can occur in the effect of chemotherapy and radiotherapy due to tissue hypoxia.
  • Since the anaemia in a cancer patient can be multifactorial, the aim of the investigation is to rule out correctable causes:
    • Complete blood count
    • Reticulocyte count
    • Peripheral blood smear
    • Nutritional evaluation e.g. Iron studies
    • Hemolysis: DCT, ICT
    • Bone marrow examination
    • EPO estimation
  • Treatment:
    • No single regimen
    • Varies according to causes and presentation
    • Red cell transfusion is needed in case of haemorrhage and severe symptoms.
  • Causes:
      • AIHA: steroids
      • Nutritional deficiency: supplementation
      • Erythropoietin (EPO) reduces the number of patients requiring blood transfusion.
Omega Hospitals Team

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Published by
Omega Hospitals Team
1 year ago

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