Fatigue
Cancer and Chemotherapy-Induced Anemia and Fatigue

Anemia, an abnormally low level of red blood cells, is a common complication of cancer and treatments such as chemotherapy and radiation therapy. Both cancer and its treatment can interfere with the supply of red blood cells - by inhibiting the production of bone marrow, or as a result of chronic blood loss during surgery. Although it is seldom life-threatening, cancer-related anemia can cause overwhelming fatigue, and may have a severe impact on quality of life.

• Prevalence. Although there is no accurate estimate of its prevalence among people with cancer, evidence suggests that most people with cancer will develop anemia at some point during the course of their disease.



• Symptoms. Fatigue affects up to 76% of people with cancer and is the most frequently reported symptom of anemia. Other clinical symptoms of anemia include dizziness, loss of appetite, inability to concentrate, shortness of breath, and cardiovascular problems such as chest pain and elevated heart rate.



• Quality of life. Anemia and its chief symptom, fatigue, can affect quality of life in many ways. Loss of energy associated with anemia can limit a patient's ability to perform everyday activities, including work, social, and leisure activities. Fatigue also may result in emotional problems such as loss of self-esteem and depression. For some, severe fatigue may diminish a patient's ability to cope with the disease and its treatment.



• Diagnosis. Cancer-related anemia can be diagnosed with a blood test which measures the volume of red blood cells in whole blood.



• Treatment. Severe, chronic cancer-related anemia traditionally has been treated with blood transfusions as needed. However, transfusions may result in complications such as fever, allergic disorders, infections, and suppression of the immune system in about 20 percent of cases. Medications to stimulate red blood cell production are an alternative to blood-transfusion therapy. Proper nutrition, vitamin and mineral supplements, stimulants, antidepressant and anti-anxiety medication, lifestyle modifications, and even psychological counseling also may help alleviate the fatigue associated with cancer and anemia.