What is Anemia?

Red blood cells (RBCs) are responsible for transporting oxygen throughout the body and exchanging gases with tissue cells to meet energy demands. Anemia occurs when the number of RBCs or hemoglobin (Hb) levels fall below the normal range (14–18 g/dL for men and 12–16 g/dL for women). Cancer patients frequently experience anemia because the disease itself, as well as treatments such as chemotherapy, radiation therapy, and bone marrow transplantation, suppress bone marrow function.

Causes of Anemia

• Primary or Metastatic Tumors: Direct invasion or effect of cancer cells on healthy tissue and blood formation.
• Chemotherapy: Chemotherapeutic agents cause bone marrow suppression, reducing blood cell production.
• Radiation Therapy: High-dose radiation targeting areas rich in bone marrow impairs hematopoietic (blood-forming) capacity.
• Surgical Resection of Gastrointestinal Cancers: Surgical removal of parts of the stomach or intestines can lead to a loss of stomach acid and intrinsic factor, impairing the absorption of iron, vitamin B12, and folic acid.

Symptoms of Anemia

• Mild Symptoms: Pale complexion, dizziness, fatigue, general weakness, cold sweats, and palpitations.
• Severe Symptoms: Confusion, lethargy, shortness of breath (dyspnea), hypotension, shock, and potentially death.

Daily Care & Precautions

1. Daily Activities & Fall Prevention

• Slow Postural Changes: Change positions slowly. Use a progressive method when getting out of bed: turn onto your side $\rightarrow$ sit up slowly $\rightarrow$ stand up only if you feel no dizziness or discomfort (as shown in the diagram).
• Conserve Energy: Avoid overexertion and ensure adequate rest to decrease tissue oxygen consumption and reduce fatigue.

2. Dietary Considerations

• Iron & Folic Acid-Rich Foods: Incorporate red meats (e.g., beef), salmon, nuts, dark leafy greens (e.g., spinach), animal liver, and egg yolks.
• Vitamin C-Rich Foods: Vitamin C enhances iron absorption. Include oranges, lemons, apples, grapes, and tomatoes.
• Protein-Rich Foods: Protein increases iron solubility and aids absorption. Consume milk, eggs, lean meats, fish, and soy/legumes.
• Vitamin B12: Essential for red blood cell formation and normal nerve function. It is naturally present in animal-derived foods (e.g., milk, eggs, meat). Vegetarians should consider vitamin B12 supplementation, paired with folic acid as needed.

3. Medical Interventions

• Manage Chronic Bleeding: Early medical evaluation and treatment for ulcers or chronic bleeding are essential to prevent worsening anemia.
• Transfusion & Erythropoietin (EPO): When clinically necessary, physicians may prescribe blood transfusions or administer erythropoiesis-stimulating agents (EPO) to raise RBC levels and relieve severe symptoms.