Cancer Medical Care | Side Effects of Chemotherapy | Improve Anemia | Improve Low Red Blood Cells | Improve Low Hemoglobin (Decrease/Decrease/Decrease/Insufficiency)

Cancer Medical Care | Side Effects of Chemotherapy | Improve Anemia | Improve Low Red Blood Cells | Improve Low Hemoglobin (Decrease/Decrease/Decrease/Insufficiency)

Cancer medical care

Chemotherapy side effects

Low red blood cells | Decreased red blood cells | Insufficient red blood cells |  Anemia  

1. The causes of anemia during cancer treatment | erythrocyte decline reasons 

2. Symptoms of anemia | Symptoms of erythrocytopenia

3. What problems may anemia cause? | Problems that may be caused by red blood cell reduction

4. Treatment of Anemia|Treatment of Erythnocytopenia

5. What should I do when I have anemia? | What should I do when the red blood cells fall?

6. Hygiene and cleanliness that should be maintained when anemia | Hygiene and cleanliness that should be maintained when red blood cells are falling

7. Precautions for diet when anemia | Precautions for diet when red blood cells are falling

8. Exercise moderately and regularly when anemia | Exercise moderately and regularly when red blood cells are falling

1. Causes of anemia during cancer treatment | Causes of red blood cell decline     

After the patient received chemotherapy, radiotherapy or surgical resection, the internal organs were severely damaged; the hematopoietic system mainly includes organs such as liver, spleen, kidney, thymus, lymph nodes and bone marrow, all of which were affected by different degrees of injury, and caused by a certain degree of injury Inhibition of cell growth and metabolism in normal body.

Since the bone marrow is the main hematopoietic tissue, almost a certain degree of "bone marrow suppression" occurs after chemotherapy and radiotherapy, which causes the side effect of blood cell reduction.

The degree and time of the decline vary greatly depending on the type and dose of chemotherapy drugs, as well as the patient's bone marrow function and the sensitivity of hematopoietic cells to drugs.

Usually it will reach a minimum within 7-14 days after the end of treatment, and then slowly rise again. Therefore, the risk of fever and infection most often occurs between the 10th and 14th days.

2. Symptoms of anemia | Symptoms of red blood cell reduction  

When anemia occurs, the number of red blood cells decreases and the ability to carry oxygen decreases , resulting in hypoxia and shortness of breath or wheezing.


Anemia usually starts slowly, so you may not notice the symptoms at first. As your hemoglobin level decreases, you may experience one or more of the following symptoms:


• Loss of appetite

• Menstrual disorders

•Pale skin (lips, eyelids)

• Get up easily and get dizzy and dizzy

• Hypothermia

• Activity impaired


• It’s hard to concentrate

• Fast heartbeat (accelerated heartbeat)

• Breathe fast

• Shortness of breath (dyspnea)

• Difficulty breathing during activities such as walking, climbing stairs or talking

• Dizziness or dizziness

• Chest pain

• Swelling of hands and/or feet

• The skin, nail bed, mouth and gums look paler than usual

• Extreme fatigue (easy to fatigue)

Anemia can range from mild to life-threatening, depending on your hemoglobin level and symptoms. Some of these symptoms are more severe than others.

Your doctor will explain your hemoglobin level and the severity of anemia.

If you have any of these symptoms, please tell your doctor or nurse immediately.

Let your cancer care team know if you have other medical problems, such as heart or lung disease, as this may worsen the symptoms of anemia.

It is important to pay attention to anemia and its symptoms throughout the treatment. If you have any of the symptoms described here, please tell your healthcare team.

Be sure to mention how the symptoms affect your daily life. Doing so will help you get the treatment you need when you need it.

3. What problems may anemia cause? | What problems may be caused by red blood cell reduction?  

• The first thing a doctor needs to know is how severe your anemia is.

• Anemia can affect your quality of life, and it has been found that anemia can shorten the survival time of cancer patients. Because the cells in the body cannot absorb enough oxygen, this can make you feel very tired. In some cases, this lack of oxygen may be enough to threaten your life.

• Anemia also makes your heart work harder. Therefore, if you already have heart disease, anemia can make the situation worse.

• Anemia can also make it difficult for you to breathe normally, which makes it difficult for you to perform daily activities.

• Severe anemia may mean that you must delay cancer treatment or reduce the treatment dose. It may also cause certain cancer treatments to not work properly.

4. Treatment of Anemia|Treatment of Erythnocytopenia

There are two main goals in treating anemia:

•Treat the cause of anemia

• Increase hemoglobin levels and improve symptoms

The most common treatments for anemia in cancer patients include:

•Iron treatment:

•Blood transfusion

• Erythrocyte production stimulant (ESA)

• Other drugs

Your doctor will check your test results, symptoms, time of symptoms, cancer type, cancer treatment, and other factors. Discuss with your healthcare team the treatment that is right for you. As with any medical problem, the expected benefits of treatment should always outweigh the possible risks.

•Iron treatment: 

(1) Oral iron: Generally, it takes 4-6 months to supplement the iron storage. Iron is better absorbed when taken on an empty stomach. Do not take it with calcium tablets, oatmeal, yogurt, cheese or milk, as it will reduce iron absorption.

The possible side effects of oral iron are: diarrhea or constipation, upper abdominal discomfort, heartburn, abdominal pain, allergies (itch, rash), nausea, and vomiting. It is harmless to take iron to darken the stool.

(2) Iron injection: The indications for using intravenous iron are: the patient cannot tolerate gastrointestinal discomfort caused by oral iron, the rate of iron (blood) loss exceeds the rate of oral iron absorption, and the inability to swallow or absorb iron due to illness 、Patients with inflammatory bowel disease or chronic kidney disease.

The possible side effects of iron injection are: flushing, muscle pain, joint pain, headache, dizziness, low blood pressure, sweating, nausea, vomiting, diarrhea, allergies (itch, rash, urticaria, allergic shock).

Risk of blood transfusion 

• Blood transfusion reaction: The patient's immune system attacks foreign blood cells. This usually looks like an allergic reaction. Most of these reactions are mild and treatable, but sometimes they can be more severe.

• Lung injury related to blood transfusion: This is one of the more serious risks. It can cause breathing difficulties and requires treatment in the hospital.

• Exposure to certain bacteria, such as hepatitis B or C viruses.

• Risks associated with blood transfusion (TACO): This can happen if the blood supply is too fast for the heart to process.

• Iron overload: People with a lot of blood transfusions may end up taking too much iron and then need to be treated.

Erythropoiesis agent (ESA) 

The effect of ESA is similar to a hormone produced by the kidneys (called erythropoietin), which can help the body produce its own new red blood cells.

Drugs can cause very serious side effects (can induce cancer cell proliferation, cancer cell blood vessel proliferation, cell lymphatic hyperplasia, increase the rate of cancer cell proliferation, prone to blood metastasis, lymphatic metastasis, prone to deterioration and recurrence problems).

Nonetheless, it can help patients increase their hemoglobin levels and reduce the number of blood transfusions required. Please discuss the risks of ESA with your doctor.

Other medicines to treat anemia

Depending on the type of anemia, vitamin B12 or folic acid supplements can also be used to treat anemia.

Talk to your doctor about what kind of anemia you have, the recommended treatments, and the risks of treatment.

5. What should I do when I have anemia? | What should I do when the red blood cells are falling? 

•Appropriate rest and activities. Only do activities that you can tolerate

• Record your symptoms, when they occurred, and the reasons that made them worse or worse

• If you cannot move around as usual, please tell your medical team.

• When you are full of energy, plan your important activities.

• Drink 8 to 10 glasses (2000CC) of water a day, unless your healthcare team has other instructions.

• You can drink other liquids instead of water, but not beer, wine or other alcoholic beverages.

•Appropriate amount of exercise, at least 30 minutes each time, at least 3 to 5 days a week.

• Strenuous exercise, staying up late and overwork should be avoided.

•Should have adequate rest to avoid the consumption of a lot of physical strength and nutrients.

• If the anemia is too severe, it is not suitable for exercise.

• Stand up slowly to avoid falls due to dizziness and fainting

• When changing postures, such as getting up from a chair or getting up, you should slow down. You can sit on the edge of the bed for 5 to 10 minutes, and it is best to be accompanied.

•Reduce excessive social activities and avoid aggravating physical burden.

6. When anemia should maintain hygiene | should maintain hygiene when red blood cells fall 

• Pay attention to the cleanliness and hygiene of the integrity of the oral cavity, skin, and anal mucosa.

•Do not pick your nose with your hands to avoid damage to the nasal mucosa.

•Should use a soft toothbrush to brush your teeth

• Keep bowel movements smooth

• Avoid bleeding in the nasal cavity, gums, and anus, which will affect the changes in the condition.

7. Precautions for diet when anemia | Precautions for diet when red blood cells are falling : 

  • Eat a balanced diet, because sufficient calories and protein can provide energy and restore normal cells that have been injured.

  • Do not eat uncooked food, such as lettuce salad, sashimi, etc.

  •Avoid drinking commercially available beverages containing ice cubes, hand shake beverages

  • If there are no special restrictions, you should drink plenty of water every day, at least more than 2000C.C. per day.

  • Eat cooked foods and take in more vitamins and phytochemicals.

  •Comprehensive brewing of cereal powder (good digestion, easy absorption, less burden)

  •Juice (non-chemical blended juice)

  • Calcium supplement for breakfast, iron supplement for lunch and dinner. 

  •Retain calcium = Vitamin D (15-20 minutes in the sun in the morning, black fungus) + Magnesium ions (nuts, leafy vegetables, beans and whole grains)

  • Note that eating calcium, iron interval, the interval should be more than 2 hours 

  • Supplementing essential nutrients for red blood cell production = high-iron food + vitamin C (increasing absorption by 67%) + folic acid + vitamin B complex + protein

  •High vitamin C fruits and drinks after meals .

  •High vitamin C vegetables: sweet peppers, mung bean sprouts, rape, pea sprouts

  •High vitamin C fruits: Guava, papaya, kiwi, orange, grapefruit, lemon.

  •High-speed iron foods: dragon fruit, black sesame seeds, seaweed, emperor beans, brown sugar, black beans, red amaranth, red phoenix vegetables, dark green vegetables, yuba, emperor beans, pumpkin seeds,

  •Inhibition of iron absorption: Tannin (tea, coffee), oxalic acid (spinach, chocolate, tea), acid (corn, whole grains, beans), egg yolk, calcium, zinc, manganese...Supplements (tablets). 

  • Avoid obstructing the absorption of iron. It is best not to drink tea or coffee for two hours before and after meals.

  • Fermented soybean products, such as miso, natto, etc., have a better iron absorption rate than soybeans; phytic acid will be destroyed in the process of germination and fermentation, thereby reducing the interference of phytic acid on iron absorption and improving iron absorption.

  • Adding vitamin C can also inhibit phytic acid in cereals and improve iron absorption.

  • Avoid taking it with calcium, zinc, manganese... supplements (tablets) at the same time.

   • radiotherapy, bone marrow suppression of adverse reactions (after chemotherapy appears white blood cells is too low , lack of red blood cells, platelets deficiency), in Chinese medicine are weak blood, kidney deficiency, liver and kidney ... and other syndromes; commonly used qi and blood, To replenish blood, we must first strengthen the spleen and stomach.

   • For those with reduced red blood cells, the first step in replenishing blood is to invigorate the spleen and stomach. You can choose astragalus, longan, medlar, ginseng, codonopsis, red dates, ... and other medicines; Huangqi medlar and red date drink.

   • For those with thrombocytopenia, drugs such as angelica, jujube, cohosh, Ligustrum lucidum, etc. can be used.

The recommended table for high-iron foods is 100 grams

 (11-20 mg) healthy wheat flour, cereals, oatmeal
 (21-30 mg) oatmeal
 nuts and seeds:
 (  5-10 mg) mountain vermicelli, sesame paste, white sesame, aiyuzi, peanut powder
 (11-20 mg) Lotus seeds, white melon seeds
 (21-30 mg) Peanuts, sesame sauce
 (11-20 mg) Prunes, red amaranth
 (above 30 mg), seaweed, and
 (  5-10 mg) Red beans, pinto beans, black beans, soybeans, mung beans
 (11-20 mg) Emperor beans, tempeh
 (11-20 mg) wolfberry
 (above 30 mg) brown sugar
 Main source of brown sugar : "Taiwan Food Nutrition Information Database", administrative Published by the Department of Health

High-speed iron drinks (beaten into juice)

1. Ingredients: half an apple, 1 orange, 50g cabbage, 20g celery, 60g beetroot, 5 cashews, 2 tablespoons of brown sugar, 300CC of boiling water

nutrient content






Vitamin C








2. Ingredients: 100g purple cabbage, half lemon, 80g tomato, 1 apple, 2 brown sugar soup, 5 walnuts, 300cc of boiling water

nutrient content






Vitamin C







8. Exercise moderately and regularly when anemia | Exercise moderately and regularly when red blood cells are falling

Exercise can promote bone marrow blood flow and maintain normal hematopoietic function.

The bone marrow in the bones is the main hematopoietic tool of the human body, which contains a large amount of red bone marrow that can produce many hematopoietic stem cells, and provide sufficient blood supply for the human body. If there is not enough blood supply, the bones will not get adequate nutrition, and a series of diseases will appear.

Quantitative and moderate exercise, especially should enhance aerobic exercise, increase the oxygen content of cells. Such as: walking slowly, jogging, yoga, lengthening the breathing time; inhale evenly and slowly, hold your breath, and exhale slowly. From 20 seconds, slowly extend to 1 minute, or longer. It can increase the activity of hematopoietic stem cells, thereby achieving the purpose of enhancing the hematopoietic function of bone marrow; at the same time, it can also strengthen the strength of bones and make bones stronger and healthier.

If you have religious beliefs, you can chant silently; pray, confess

Christianity, Catholicism: Hallelujah, Hallelu Yah

Islam: Allahu akbar

Buddhism: Amitabha

No religious belief : I'm sorry, I love you, please forgive me, thank you

There are two main reasons leading to the decline of bone marrow hematopoietic function: 

The first is the lack of exercise and the weakened ability of cells to make blood. Without proper regular exercise, it is useless to eat more nutrients; if a factory imports a lot of materials and does not have normal production operations , it will not be able to produce products. Just hoard a lot of materials. Exercise produces blood circulation, which can effectively produce red blood cells, white blood cells, and platelets  .  

The second is malnutrition and lack of hematopoietic materials. Including protein, iron, vitamin C, vitamin B complex, folic acid, amino acids, trace elements, vitamins and other nutrients. Need to develop good eating habits. 

Protein is not big fish or big meat;; after chemotherapy, a certain part of the gastrointestinal tract is damaged, so the work and burden of the gastrointestinal tract must be reduced. Therefore, food is easy to digest and easy to absorb, such as: soy milk, tofu, plant milk, comprehensive brewed cereal flour, ... and so on.

Exercise for at least 30 minutes each time and at least 3 to 5 days a week. However, strenuous exercise, staying up late and overwork should be avoided, and adequate rest should be taken to avoid a lot of physical strength and nutrient consumption. If the anemia is too severe, it is not suitable for exercise.

When changing your posture, such as getting up from a chair or getting up, you should slow down. You can sit on the edge of the bed for 5-10 minutes, and it is best to be accompanied by someone to avoid falling down due to dizziness and fainting.

The best solution for cancer cells

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