Cancer treatments have improved over the years, but powerful chemo drugs can still damage the body, particularly the bone marrow where blood cells are made. Both red and white blood cells can be affected, leading to anemia and possible infection, but following a healthy diet may help in some cases.
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"Red blood cells, white blood cells and platelets are made in the bone marrow, and some cancer treatments, like chemotherapy and radiation, make it more difficult for the marrow to produce a normal amount of each," explains Rachel Dudley, RD, a clinical dietitian at the Dan L. Duncan Comprehensive Cancer Center in Houston.
According to the American Cancer Society, certain risk factors make it more likely for a person undergoing cancer treatment to have a low red blood cell count, which is also called anemia. These include being treated with platinum-based chemo drugs, having a certain type of tumor (lung, ovary) and having a low level of hemoglobin (the protein in red blood cells that carries oxygen) before cancer treatment begins.
Here's more about how cancer treatments may affect blood counts, whether diet can improve blood cell levels and the right foods to eat if anemia is an issue.
How Cancer Affects Your Blood Count
Chemotherapy uses a variety of powerful chemicals to fight cancerous cells — and low blood cell counts may be a complication of this treatment, notes the Mayo Clinic. Radiation therapy, bone marrow and blood cancers (such as leukemia) and cancers that have metastasized can also cause low blood cell counts in the body. "Radiation, especially if it's directed at the bone, can lower blood counts by causing damage to the bone marrow, but they should return to normal levels following the treatment's completion," notes Dudley.
One of the most common side effects of chemo is anemia. It's prevalent in 30 to 90 percent of patients with cancer, according to treatment guidelines published November 2017 by the National Comprehensive Cancer Network. Other chemo side effects include nausea; hair loss; constipation or diarrhea; fatigue; fever and body aches.
Can You Raise Blood Counts During Chemotherapy?
Anemia occurs when you experience a lowered level of red blood cells, which are necessary to carry oxygen to every cell in your body. Without enough oxygen in the bloodstream, you may feel short of breath and tired. "While there is no specific diet to follow that can be used to improve blood counts, proper nutrition is key during cancer treatments to maintain overall health," says Dudley.
Not eating well means you might miss out on vital nutrients, specifically iron, vitamin B12 and folate, which are all needed to produce red blood cells. "It's preferable to obtain these nutrients from food sources," she adds. So while diet doesn't play an immediate role in raising blood counts, eating right throughout treatment means concentrating on whole, unprocessed foods and quality protein.
The same is true for infection-fighting white blood cells, per the Oncology Nutrition section of the Academy of Nutrition and Dietetics. No particular foods or diet plans have been shown to increase white blood cell counts in people who are undergoing cancer treatment, but a focus on quality protein can help. The amino acids found in protein help the body to make more white blood cells.
How to Achieve Optimal Blood Cell Health During Chemo
Eating iron-rich foods can promote the production of red blood cells. There are two types of iron available in food form: heme, which is found in animal products, and non-heme, a plant-based source, according to the experts at the Stanford Blood Center.
"Heme iron is more readily absorbed by the body and is found abundantly in meats and seafood, while dietary sources of non-heme iron include fortified grain products, beans, nuts and some vegetables," reports Dudley.
Non-heme iron is harder for the body to absorb fully, but if you eat non-heme items with foods rich in vitamin C, iron absorption can be improved. Ones to try: fresh fruits such as citrus, pineapple and strawberries, or vegetables like spinach, tomatoes, peppers and broccoli.
Vitamins B12 and folate are also important components when it comes to red blood cell production. "Vitamin B12 is found predominantly in animal-based food sources like red meat, poultry, fish, eggs and milk products and isn't naturally found in plant sources, though some cereals have been fortified with this nutrient," notes Dudley.
As for folate, also known as folic acid, look to such foods as red meat, poultry, seafood, milk products, eggs, fortified grains, nuts, beans and fruits and vegetables, especially dark leafy greens.
"Iron, vitamin B12 and folate may also be taken in supplement form, but it's important to discuss any potential supplement use with your doctor or dietitian prior to taking one," Dudley warns.
As mentioned, your white blood cell level may also drop due to cancer treatment, though a dietary solution isn't possible in this case. "While there are no specific foods, vitamins or minerals that can help increase white blood cells, it's important that people with low counts practice good hand hygiene and food safety to minimize a risk of infection," says Dudley.
If you have a low white count, avoid all raw meats, including seafood, sushi and raw eggs, and be sure to consume milk and other dairy products, juices and honey that are pasteurized. "Contrary to popular belief, it's not necessary for people in cancer treatment to avoid all fresh fruits and vegetables as long as they are washed before eating," Dudley adds.
- Stanford Blood Center: "How to Keep Your Iron Levels up on a Vegan (or Vegetarian) Diet"
- Mayo Clinic: "Low blood cell counts: Side effect of cancer treatment"
- American Cancer Society: "Anemia in People With Cancer"
- Oncology Nutrition, Academy of Nutrition and Dietetics: "White Blood Count & Diet"
- National Comprehensive Cancer Network: "Cancer- and Chemotherapy-Induced Anemia"