Up to 90% of all people with cancer develop cancer-induced anemia. Anemia is a condition in which you don’t have enough normal, healthy red blood cells to provide oxygen to your body. Unfortunately, anemia may already have been present when you were diagnosed with your cancer, or it may develop as a result of your treatment, particularly if you’re having chemotherapy. If you have anemia, you could be more likely to experience problems, such as shortness of breath or extreme fatigue, which can significantly impact your quality of life. If you’re concerned about anemia or are having symptoms, it’s best to talk with your doctor. He or she can help to determine the cause of your symptoms and recommend treatments to help you feel better. What is anemia? Red blood cells are made in your bone marrow, and each red blood cell contains an iron protein called hemoglobin that “carries” oxygen molecules to the tissues and organs of your body. When you have anemia, your body isn’t making enough red blood cells, or the red blood cells you have are somehow damaged or destroyed. Many people with cancer-induced anemia experience symptoms such as: Extreme fatigue Weakness Shortness of breath Lightheadedness or dizziness Headache Cold hands and feet Pale skin or lips Chest pain Bleeding problems In many cases, anemia starts out as a mild issue, and it’s easy to go unnoticed because you may not have any symptoms. However, the longer anemia goes untreated, the worse symptoms usually get. Because of this, you may find it difficult to stick to your cancer treatment schedule and participate in daily activities you once enjoyed. Most often, anemia is caused by iron deficiency. This means your body doesn’t have enough iron, which is used to make hemoglobin. Iron is typically absorbed from food in the small intestine, and, for many people with cancer, this process becomes difficult because of the cancer itself or some cancer treatments. Some cancer therapies, like chemotherapy, cause anemia by damaging your bone marrow where red blood cells are made. Chemotherapy works by killing cells that grow quickly, like cancer cells. But because chemotherapy isn’t a targeted treatment, it also works against normal body cells that multiply quickly, such as bone marrow cells and the cells lining your digestive tract. How is anemia diagnosed and treated? If you have symptoms of anemia, your doctor can perform several tests to determine the cause of your symptoms. Usually, blood tests are used to check your iron level, and to check the levels of other vitamins and minerals you have in your body. Blood tests can also show how the rest of your body is functioning, including whether your bone marrow is producing new red blood cells. If needed, your doctor can take a sample of your bone marrow to determine how well it’s functioning. Depending on the cause of your anemia, several treatment options may be available to help manage your symptoms: Iron-rich foods: If you have mild anemia, it may only be necessary for you to eat more iron-rich foods, like dark green, leafy vegetables, beans, and certain meats and fish. Iron supplements: Your treatment may be as simple as taking an oral iron supplement every day, or if you can’t tolerate the side effects of oral iron, you can receive it via infusion. Changing cancer treatment: Only your doctor can tell you whether changing your cancer treatment can help to correct your anemia. He or she may decide to change your chemotherapy to another option that still treats your cancer while also improving your anemia. Blood transfusions: Many people with cancer receive donated blood intravenously (IV) to help raise red blood cell and hemoglobin levels quickly. Medications to spark red blood cell production: Certain injectable medications can help stimulate your body to produce more red bloods cells. You may need to receive several injections, and these medications can take several weeks to begin working. While cancer-induced anemia can cause many unpleasant symptoms, it’s possible to find effective treatment that can help manage your symptoms and return you to a better quality of life. Talking with your doctor about your symptoms and how they’re affecting your life is the first step to determine the cause of the problem and find a treatment that works best for you.