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Anemia, cancer, and aging
1Senior Adult Oncology Program, H. Lee Moffitt Cancer Center Research Institute, Tampa, FL 33612, USA. balducci@moffitt.usf.edu
Background:
Anemia is an issue of concern in the management of older patients with cancer. In this age group, the incidence and prevalence of both cancer and anemia increase with age.
Methods:
The clinical consequences and the management of anemia, a common comorbid condition in older patients with cancer, are explored.
Results:
Common causes of chronic anemia include iron deficiency and anemia of chronic disease. The prevalence of vitamin B12 deficiency due to reduced absorption of food-bound vitamin B12 also increases with aging. Although in many cases the cause of anemia is not found, a primary deficiency of erythropoietin may be at fault in at least some of these cases since the response of erythropoietin to anemia may decrease in individuals over age 70.
Conclusions:
Anemia should not necessarily be ascribed to cancer or aging. The causes of anemia should be pursued and reversed, and hemoglobin levels should be maintained at a minimum of 12 g/dL in cancer patients undergoing chemotherapy who are responsive to erythropoietin. The reversal of anemia may offset or delay the accumulation of catabolic cytokines that may be responsible for functional decline in aging individuals.
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