What Is The Relationship Between Cancer And AnaemiaHealth A-Z | January 4, 2010
Anaemia means a medical state of inadequate number of red blood cells in the blood circulation. This can be the result of many reasons or factors such as lack of folic acid, iron, or B12 vitamin. Lack of red blood cells makes it difficult to carry oxygen in the different parts of the body through blood. This is because the chief function of the red blood cells is to supply oxygen to the different parts of the body. Due to oxygen supplying difficulty, anaemia is one of the major reasons for breathlessness and tiredness.
Cancer is a medical term for presence of malignant tissues in the body irrespective of the type or location. Actually, anaemia and cancer both can give rise to each other, the more strong being cancer giving rise to anaemia.
If anaemia due to iron deficiency is severe, it sometimes causes mutations in the soft lining in the throat that is the beginning stage to cancer. On the other hand, cancer can give rise to anaemia through different means, which are listed below.
- The direct effects of the cancer cells in the body
- Biologically active products of the cancer cells
- Outcome of the treatment of cancer
If we look at the main means through which the different types of anaemia occur, it can be well comprehended how cancer-related anaemia occurs.
Types of Anaemia
Generally communicating, there are two types of anaemia. Listed below are these two types.
- One in which red blood cells are lost very rapidly, for instance, due to:
- Bleeding, specifically when this has been on for reasonable amount of time.
- More weak red blood cells, which indicates that their life expectancy is small.
- One in which the required number of red blood cells are not produced in the bone marrow. This can be because of the disease of the bone marrow or deficiency of the building blocks of blood such as iron or a few vitamins. The presence of any of these conditions weakens the production process of red blood cells.
It is often observed that in case of anaemia, more than one cause is present simultaneously.
Blood Loss Causing Anaemia and Cancer
In the digestive system, some tumors tend to bleed very gradually such that the bleeding is not so apparent and hence is not detected. It is only over a long period of time that the person finally experiences extreme tiredness and visits the doctor for diagnosis of anaemia.
- This is dependent on the proportion between the lost rate of blood and the body’s capability to replace the red blood cells. If the blood lost is faster than the rate of replacing new cells, the bleeding’s effect can be experienced and detected. A healthy bone marrow produces approximately 20ml of fresh blood daily.
- The other restricting factor in long-term blood loss is the accessibility of the raw materials by the bone marrow to function well. One such important constituent is the iron contained in the oxygen-holding particle called haemoglobin present within the red cells. Therefore, if there is not enough level of iron, the production of red blood cells will be impaired.
If there is a cancer of the large bowel, stomach, or gullet, anaemia due to iron deficiency can co-exist together. Very common, anaemia is the only way to find out the source of bleeding. Luckily, not all bleeding sources can be the location or cause of cancer. So, if any person suspected of iron deficiency anaemia having no apparent cause must be examined for the bleeding point in the digestive system. Needless to say, regular or long time bleeding can lead to iron deficiency, so certain obvious sources of bleeding such as urine, stool, or womb must be checked.
People with cancer of gullet or stomach might find it difficult to swallow a normal diet, so to avoid iron deficiency anaemia, supplement of vitamins and minerals becomes inevitable. Further, even due to cancer, there can be loss in appetite that simply adds to nutritional or diet problems. So, proper diet or intake of different vital nutrients through means of tablets and drinks is necessary.
Bone Marrow Failure Causing Cancer and Anaemia
The bone marrow is the production house of red blood cells. Let’s suppose that tumor has developed in one part of the body. If some of the cancer cells of the tumor drop themselves in the blood, there is a possibility that these cancer cells enter and dwell in the bone marrow through circulation; as cancer cells spreads through circulation (metastasis). Therefore, the bone marrow is also not left by the cancer cells to deteriorate. Among all the cancers that can do so, the breast, prostate, and lung cancer are the most common ones.
In the bone marrow, the cancer cells are supplied with good amount of blood, which is enough for them to multiply and grow in numbers. This results in tumor that enlarges and covers the increasing bone marrow space that in turn, impairing the production of new red blood cells. The tumor must really replace a large amount of bone marrow, as the bone marrow has good amount of capacity. Listed below are some more cancers that result in anaemia.
- Advanced stage of cancer (having extensive metastasis) in which the body’s metabolism does not function properly for which the ‘why’ part is not yet clear
- Tumors from the bone marrow such as certain leukaemias and multiple myeloma
Consequences of the Cancer Treatment
The main characteristic of cancer cells is that they multiply very fast as compared to the normal cells. This feature itself is the weakness of cancer cells, whose full benefit is taken by the cancer treatment.
The genetic information and the DNA of every cell are held within its chromosomes present in the nucleus. To reproduce or multiply, a cell is divided into two, which involves replica of the chromosomes and then its division into two that offers each new cell with an individual collection of chromosomes. This process of cell reproduction is a multifarious process that consists of multiple steps.
The treatment of cancer is based on the fact that the split cell is more likely to interfere with this copying action. The drugs used to treat cancer are made in such a manner that they prevent the copying action of chromosomes, which in turn, blocks the cell from splitting or multiplying.
Frankly speaking, it is very tough to formulate a cancer drug that will prevent the splitting of cancer cells, not involving the normal cells. Cell production is the usual process, which is the part of continuously managing (renewal and repair) the cells of the body. Therefore, the drugs of the cancer treatment inevitably affect the normal cells. This impact is apparent in tissues whose rate of renewal is high. For example, hair that is often lost during the treatment of the cancer.
Another example is bone marrow, which is an active tissue and the effect of cancer on it can cause anaemia. Drugs that contain platinum such as Carboplatin (Paraplatin) or Cisplatin and X-rays are more likely to damage bone marrow, the latter causing anaemia.
The bone marrow is also the producer of white cells required to fight infections, a cancer person undergoing through the treatment is more likely to be infected if there is a significant drop in the number of white cells.
Anaemic Fatigue in Cancer
Fatigue due to anaemia is a major reason of disability in cancer patients. Further, fatigue can be even due to depression and lack of sleep if not treated. For a disabling condition, the palliative care offered to cancer patients should focus on improving their quality of life. So, if fatigue is found in cancer patients, a cause must be detected and treated.
Treatment for Anaemia Caused due to Cancer
The straightforward way to treat this anaemia is to look out for its cause and rectify it as soon as possible. For example, a bleeding bowel tumor can lead to iron deficiency anaemia that might be treated with the iron tablets. However, a true treatment must be such that it removes bowel cancer.
In cases where anaemia cannot be treated directly, two major alternatives do help namely blood transfusion and erythropoietin therapy.
Blood transfusion is common in the U.K. as a treatment for number of difficulties, even though its procedure and arrangements is complex in nature. For many people, blood transfusion is easy, meaning they can endure it and that it might be performed as an outpatient procedure.
For people with cancer-related anaemia, the preferred and effective way is a ‘top-up’ transfusion. If an individual’s position is really not in a good situation, periodic transfusions are performed to ensure that the haemoglobin level in the blood is above the minimum mark.
Due to common usage, it should not be assumed that blood transfusion is from any side effects or later problems. One of its effects is transfusion reactions, which is a type of allergic response that might obstruct the proper execution of a transfusion or might even discard it. However, the main reason behind its being a part of the routing medical treatment is that the patient can experience instant progress in its condition.
Another effect can be due to the little risk involved in transmitting the donor’s blood that might be infected. This is reason as to why the numbers of blood donations are declining in front of rising requirements for blood.
Due to these risks, the medical researchers or experts have always hunted for a treatment that can overcome or minimize the need for blood transfusion. One such successful discovery is erythropoietin. This is capable of minimizing the blood transfusion need in patients undergoing platinum-including chemotherapy and in patients requiring top-up transfusion.
Erythropoietin refers to a hormone that is generated by certain group of cells in the kidney on a large scale. Its main function is to work with the bone marrow to instigate the stem cells in it for splitting and generating more red blood cells.
The special cells in the kidney producing erythropoietin are susceptible to the oxygen levels in the circulating blood. When the level of oxygen falls in anaemia, these cells are stimulated to produce additional erythropoietin, which in turn, leads to the increased production of the red blood cells. Looking at this, you should not be astonished if I tell you that erythropoietin, after it was found, was first used in treating anaemia, rather than for kidney failure.
Gradually, erythropoietin was also found to be effective to reverse the anaemia effect of cancer-related drugs and other drugs of chemotherapy. Currently, erythropoietin is produced through the gene technology wherein genetically mutated bacterias such as Eprex and NeoRecormon are utilized. However, the use of this hormone in the treatment is still costly, but study is going on to bring out the efficient and effective ways of using it in cancer-related anaemia.
The use if erythropoietin is also effective in the treatment of cancers such as lymphomas, multiple myeloma, and lung cancer.
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