The average person's body contains 3 to 4 g of iron, explains USDA nutritionist Richard J. Wood in "Modern Nutrition in Health and Disease." Cancer patients often fall short because of decreased intake, decreased absorption, increased losses or some combination of the three. However, many cancer patients also suffer from anemia of chronic disease, a condition where the body cannot use the iron it has. Ask your doctor if iron supplements are right for you.
Tests
If you have cancer, your doctor will probably order a battery of blood tests to assess the amount of iron you have, as well as your body's ability to use it. Low hemoglobin, hematocrit and red blood cell count suggest iron deficiency in most healthy people. Normal ferritin, a measure of iron stores, suggests the problem is anemia of chronic disease, not iron deficiency. In that case, additional iron supplements will not be useful. Your doctor may repeat the tests periodically to see if the situation changes.
Types
If your doctor feels you will benefit from iron supplements, he may recommend oral iron supplements or intravenous iron injections. Oral iron supplements are less expensive and more convenient because you can take them at home or on the go. Intravenous iron injections are expensive and inconvenient because you must receive them at your doctor's office, hospital or clinic. The procedure usually takes a few hours and you must return for follow-up every three to eight days.
Side Effects
Oral iron supplements may cause gastrointestinal side effects such as upset stomach, abdominal pain, nausea, vomiting, diarrhea or constipation. If these become troublesome or interfere with your ability to eat, ask your doctor for advice. Intravenous iron injections may cause bruising, dizziness, changes in blood pressure or, rarely, a life-threatening allergic reaction called anaphylaxis. A study published by a team of Mayo Clinic researchers in the Nov. 22, 2010, issue of the "Journal of Clinical Oncology," found that 54 percent of patients who received intravenous iron experienced moderate to severe side effects, compared with 44 percent of patients who took oral iron.
Significance
Do your best to comply with your doctor's orders. If side effects makes it impossible for you to do so, let your doctor know right away. Iron deficiency may decrease the effectiveness or increase the toxicity of radiation or chemotherapy treatments for cancer. You may have to postpone your treatment or your doctor may order a lower dose until blood tests reveal improvement. In the case of surgery, you may require blood transfusions before it is safe to proceed.
Considerations
If you have cancer, your doctor may prescribe an erythropoietin-stimulating agent, or ESA, to help your body use iron supplements. Your kidneys normally make erythropoietin. When you have cancer, they may stop making erythropoietin or they may make less than normal. Not all patients benefit from ESAs.
References
- "Modern Nutrition in Health and Disease, 10th Edition"; Maurice E. Shils, M.D., D.Sc. et al.; 2005
- "Harrison's Principles of Internal Medicine, 23rd Edition"; Anthony S. Fauci, M.D. et al.; 2008
- "Journal of Clinical Oncology"; Phase III Randomized Study of the Effects of Parenteral Iron, Oral Iron or No Iron; David P. Steensma, M.D. et al.; Nov. 22. 2010
- National Anemia Action Council: Anemia and Cancer
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