Cancer-Related Anemia
Cancer-Related Anemia: Understanding the Role of Iron Supplementation
Cancer-related anemia (CRA) is a complex condition that significantly impacts the quality of life of cancer patients. To explore effective treatment options, it’s crucial to understand the underlying mechanisms. Recent research has shed light on the importance of iron supplementation in managing CRA.
The Iron Connection
At the heart of CRA lies a condition called functional iron deficiency. This occurs when the body has adequate iron stores, but inflammation caused by cancer prevents its proper utilization. The culprit behind this iron blockade is a protein made by the liver called hepcidin, which increases in response to cancer-related inflammation.
Diagnosing Iron Deficiency
Identifying whether iron deficiency is driving anemia in cancer patients can be challenging as there are many causes of low hemoglobin, including nutritional deficiencies (iron, copper, vitamin A, and B vitamins like vitamin B12, folate, and riboflavin), treatment-related anemia (caused by chemotherapy and radiation), and reduced production of red blood cells/hemoglobin from extensive cancer involvement in the bone marrow. Important tests to determine whether functional iron deficiency is involved include:
- Complete blood count (CBC)
- Serum ferritin
- Transferrin saturation (TSAT)
- C-reactive protein (CRP)
In functional iron deficiency, ferritin levels may be normal or elevated as a response to the inflammation, while TSAT is typically low (<0.20). CRP can be helpful to assess the level of inflammation.
Intravenous Iron: A Promising Solution
Intravenous (IV) iron supplementation has emerged as an effective treatment for CRA. Numerous clinical trials have demonstrated its efficacy in improving hemoglobin levels and overall quality of life for cancer patients. This can be far more effective than oral iron supplementation as iron transport from the gut into circulation is decreased by high levels of hepcidin in functional iron deficiency.
Safety Considerations
While some practitioners may have concerns about the safety of IV iron, recent studies have shown that modern IV iron products are generally safe. Serious adverse events are rare, occurring in approximately 1 in 200,000 cases.
Natural Approaches
As naturopathic doctors, we can complement IV iron therapy with holistic ways to lower the underlying inflammation that drives functional iron deficiency. This can include an anti-inflammatory diet, anti-inflammatory supplements, exercise, and directly treating the cancer which is driving the inflammation using naturopathic and conventional approaches.
Conclusion
Understanding the role of iron in CRA allows us to provide more comprehensive care for our cancer patients. By combining evidence-based IV iron supplementation with naturopathic principles to lower inflammation, we can help improve the quality of life for those battling cancer-related anemia.
Dr. Sarah Soles, ND
