On MyLungCancerTeam, members discuss how issues like anemia affect their daily lives. “I am anemic as a result of treatment,” one member shared. “I have pale skin anyway, but I would use blush to add color because I felt I looked sick.”

Your body’s red blood cells carry oxygen from the lungs and deliver it to your cells. Anemia happens when the body doesn’t have enough red blood cells. As a result, people who have anemia may feel tired, lightheaded, dizzy, and short of breath. Other symptoms may include skin that’s paler than usual, a rapid heartbeat, and headaches. Getting proper treatment for anemia can help you feel your best while living with lung cancer.

How Cancer Increases Anemia

Most forms of cancer raise the risk of anemia, sometimes because of the tumors and other times as a side effect of cancer treatment. Cancers that affect the bone marrow are especially linked to anemia. People with colon cancer also have a particularly high rate of iron-deficiency anemia (anemia due to insufficient iron) related to blood loss.

The rate of iron deficiency in people with any form of cancer is between 29 percent and 46 percent. One simple reason for this connection is that people with cancer don’t always have a good appetite. If they’re not eating as much in general or not consuming enough iron-rich foods, they can develop anemia over time.

A condition called “anemia of chronic disease” describes the higher rate of anemia in people with cancer and other long-standing health problems. Experts don’t fully understand why this condition develops, but it’s possible that inflammation affects how the body stores and uses iron. In addition, radiation or chemotherapy to treat any type of cancer can lead to anemia as a side effect. Typically, a combination of these factors can make it difficult for people with lung and other cancers to avoid anemia.

Specific Links to Lung Cancer

Research suggests that the prevalence (commonness) of anemia in people with lung cancer is 37.6 percent. However, up to 80 percent of people with lung cancer develop anemia after chemotherapy. To prevent severe anemia, some chemo medications used to treat lung cancer, such as pemetrexed (Alimta), require taking vitamin supplements before starting treatment.

One member of MyLungCancerTeam described their journey with anemia after chemo: “I personally became very anemic, tired, nauseous, and short of breath, but after blood transfusions (l ended up with five over those 21 weeks), I felt better. It wasn’t anything I couldn’t handle.”

People with lung cancer may lose additional blood if they cough up blood. The amount of blood lost from coughing varies based on how often and how severely you have this symptom. Although coughing up blood may not be the main cause of anemia, it’s a serious symptom that should be addressed by your health care team.

Anemia can be dangerous for people with lung cancer, particularly those who’ve had surgery. In one study, anemia was associated with poorer survival rates after lung cancer resection procedures. Another study found that having anemia before lung cancer treatment is an independent risk factor for lower survival rates in people with advanced non-small cell lung cancer (NSCLC). That means that by itself, anemia raises the risk, an effect that holds true even for people who receive targeted therapies for lung cancer.

Other Potential Causes of Anemia

People can develop anemia for various reasons beyond cancer and its treatment. Losing blood from an injury, heavy menstruation, or a gastrointestinal problem (like inflammatory bowel disease) can lead to anemia. In addition, people with heart failure have a high risk of anemia due to the effects of the condition and its treatment.

Sometimes, medications for other issues, like heartburn, can keep the body from absorbing iron properly. If you take proton pump inhibitors to manage acid reflux, iron supplements may not work as well for you.

A deficiency in vitamin B12 or folate can also affect the production of red blood cells and cause anemia. Your oncology team can do tests to check if iron alone or additional deficiencies are responsible for your anemia symptoms.

Living With Anemia and Lung Cancer

Fatigue is a common issue for people with lung cancer. Anemia makes fatigue worse. If you suspect that you have anemia, your health care provider can test your blood. They may recommend treatments like iron supplements, dietary changes, blood transfusions, or adjustments to your cancer care plan to help raise iron levels closer to normal.

MyLungCancerTeam members have encouraged others to get treatment for anemia. “Take iron pills or get the infusion,” one member said. “They gave me iron infusions to help me with the fatigue, and it helped considerably.”

Always speak with your doctor before taking supplements because they aren’t safe for everyone, and they may interact with your medications.

In the meantime, you can help manage anemia-related fatigue by prioritizing how you spend your energy. Take your time, and break up energy-zapping activities to avoid wearing yourself out. When possible, ask for help and support from family, friends, and neighbors. Engaging in light exercise and taking short naps can help you get through the day.

Boosting Iron in Your Diet

Focusing on foods that replenish your iron stores can help manage anemia and give your body the nutrients it needs to feel stronger.

Examples of iron-rich foods include:

• Beans and lentils
• Chicken and turkey
• Dark leafy greens, like spinach and kale
• Dried fruits
• Enriched grains
• Fortified cereals
• Fish and seafood
• Red meat
• Tofu

If you’re experiencing appetite loss or digestive problems, meet with a registered dietitian to learn strategies for getting more iron. For example, if you have no interest in heavy meals with beef, a green smoothie with frozen spinach and fruit or a cold turkey wrap may be a more appealing way to up your iron intake. You also can improve absorption of iron from plant foods by pairing them with sources of vitamin C.

By learning more about the different ways to boost your iron levels, you can take steps to keep anemia under control.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Have you experienced severe anemia after treatments for lung cancer? If so, how did it affect your quality of life? What suggestions did you receive from your oncologist or a dietitian? Share your experience in the comments below, or start a conversation by posting on your Activities page.