Cancer and Anemia (low blood iron)
If you’re a cancer patient who has gone through conventional treatment such as surgery, chemotherapy and radiation it is likely you have experienced low iron levels at some point and maybe you still do.
Anemia is quite common even in the general population and it is estimated that as much as 25% of the world’s population anemic. In the “European Cancer Anaemia Survey”39 % of cancer patients were anemic at baseline when they were included in the survey. In those receiving chemotherapy, incidence of anemia was noted in 67 % of patients at some point during a 6 month surveillance phase.
Some very common symptoms of Anemia are:
- Weakness and fatigue
- Shortness of breath
- Sore tongue or bleeding gums
- Always cold
- Nausea and loss of appetite
- Faintness and dizziness
- Confusion and dementia
- Rapid or irregular heart beat (palpitations)
- Heart failure (in severe, chronic cases)
Anemia is characterized by a decrease in the amount of red blood cells and a decrease in the capacity of red blood cells to transport oxygen. Iron is an important trace element and plays a vital role in oxygen metabolism, uptake, and electron transport in mitochondria, energy metabolism, muscle function, and hematopoiesis (the process of creating new blood cells). Therefore iron is essential for physical functioning and wellbeing.
In cancer patients maintaining or increasing the oxygen-carrying capacity of blood cannot be overemphasized and may be the single most important factor in determining whether chemotherapy is successful.
In low oxygen environments cancer cells respond by sending out growth signals that result in increased angiogenesis (blood vessel growth). This oxygen deprivation also causes cancer cells to express other survival factors that make them highly resistant to the toxic effects of chemotherapy. It is a recognized fact that a low-oxygen environment (hypoxia) encourages tumor growth. If nothing else correcting hypoxia could hugely improve the odds of long-term survival.
Individuals should ask their doctor to test their iron levels regularly especially during treatment and in cases where a patient does not have their hematocrit and hemoglobin in the upper third of the normal range drugs such as Procrit (or Epogen) should be considered to attain these levels. Another FDA approved drug called Aranesp, also an erythropoietin agent, allows dosing every 2 weeks instead of weekly injections.
Unfortunately, many oncologists see low blood counts as normal in cancer patients and are hesitant to prescribe Procrit as it is an expensive drug and most insurance companies refuse to pay for it unless a patient is severely anemic (<10g/dL). Remember a cancer patient should aim to have levels in the high upper third range of normal for hematocrit and hemoglobin.
As a cancer patient eating a high quality, whole food diet, is essential to attaining all the vital nutrients your body needs to keep your immune system functioning optimally. Incorporate as many of these foods into your diet making sure they are organic as much as possible especially soy products such as tofu and tempeh.
Some of the best plant sources of iron include:
- Legumes: lentils, soybeans, tofu, tempeh, lima beans
- Grains: quinoa, fortified cereals, brown rice, oatmeal, whole grains
- Nuts and seeds: pumpkin, squash, pine, pistachio, sunflower, cashews, un-hulled sesame
- Vegetables: tomato sauce, Swiss chard, collard greens, dark green leafy vegetables (spinach should be lightly steamed and used in moderation due to oxalates.
Other: blackstrap molasses, prune juice
Best ways to absorb iron:
- Eat iron rich foods throughout the day
- Use cast iron cookware
- Eat non-heme (non-animal) iron foods with high quality vitamin C to increase absorption. Take vitamin C to bowel tolerance meaning when stools become lose you decrease slightly. As most of us are deficient the normal adult should take at least 3000mg daily. If you are a smoker, even more.
- Eat iron rich foods or supplements away from dairy products. Dairy products decrease iron absorption. Caseins from milk and certain forms of calcium inhibit iron absorption.
- Avoid coffee and tea when eating iron rich foods http://ajcn.nutrition.org/content/37/3/416.abstract
Please note that even if you haven’t had chemotherapy there is still a good chance your iron levels could be low due to other factors such as medications, gut bacterial overgrowth, malabsorption, unknown gluten or food sensitives and more. Therefore it is always important to have your levels checked and address properly.
If you are a cancer patient, either current or in recovery, speaking with a qualified Holistic Nutritionist trained in Nutritional Oncology can be critical to your recovery and avoiding recurrence.
National Association of Professional Cancer Coaches manual