There are several reasons for a person to require blood transfusions. This is especially true for cancer patients, as most extreme cases might need surgical operations. However, through successive research in the field, this need begins to appear as a double-edged blade. Scientists are becoming more aware of the unfavorable consequences of blood transfusions. While the exact reason for this is still unresolved, researchers are still debating whether this correlation between blood transfusions and its side effects on cancer is merely coincidental. In this discussion, we will try to uncover the conclusions of recent studies. We will do so while exploring cancer through its different types.
Why do cancer patients need blood transfusions?
Normally, a person would need a blood transfusion due to blood-related diseases such as excessive bleeding disorders, anemia, sickle cell disease, and thalassemia. Depending on the disease and the doctor’s diagnosis, blood transfusions require whole blood products or only blood components. These components include the following:
- Red Blood Cells: responsible for oxygen and nutrient transport all over the body. Typically required for anemia, sickle cell disease, and thalassemia.
- Platelets: responsible for sealing wounds. Typically administered for disorders in clotting factor proteins that can lead to excessive bleeding.
- Blood Plasma: the fluid component of the blood. Typically administered for diseases affecting the white blood cells and the immune system.
For a patient with cancer, the need for blood transfusions can be more specialized and requires a thorough examination by their doctor. Doctors may require blood transfusions for cancer patients in cases such as:
- Cancer Complications: internal bleeding caused by some cancers can possibly lead to anemia. Long-term cancer can also naturally lead to anemia if the cancer affects blood cell production.
- Vulnerable Organs: some parts of the body are vulnerable to disruptions in the blood due to cancer. Cancers affecting the bone marrow, kidneys, and spleen can lower blood cell count because these organs regulate the blood cells in the body.
- Cancer Therapies: chemotherapy and radiation therapy can lower blood cell count and induce internal bleeding.
- Surgeries: depending on the conditions during the surgery, the doctor may opt for blood transfusions. The typical reason for this is internal blood loss during the operation.
Blood transfusion and its impact on cancer
Out of the four cases in which doctors require a blood transfusion for a cancer patient, surgery is the most crucial. Surgeries can expose a patient to bleeding and infection. This is why it is also the topic most researched by scientists regarding blood transfusions.
While the effects of blood transfusions on cancer surgeries are still debatable throughout the decade, more and more studies have sprung up, unveiling the correlations between the two. To view these studies from a wider perspective on cancer, we will discuss studies focusing on different kinds of cancer.
Hepatic Cancer
As we discuss more about the blood, it is only appropriate to explore first the cancer related to it. Hepatic cancer affects the liver. This organ is responsible for processing the blood that runs through our stomach and intestines.
A 2019 study examined 1,469 patients regarding their hepatocellular surgery and how it affected them post-operation. The researchers associated blood transfusions during the operation with cancer survival and cancer recurrence.
Particularly, high amounts of blood transfusion units can lead to lower survival and higher cancer recurrence. The researchers suggest that high cancer recurrence rates could be due to changes in the immune system after the operation. These changes can cause tumor proliferation, healthy cell deaths, and an increased ability of cancer cells to travel throughout the body.
Colorectal Cancer
In a larger cohort study involving 4,030 patients investigated from 2005 to 2014, researchers once again studied recurrence and mortality in another type of cancer. Similar to the study on hepatic cancer, this study also notes that there are links between higher blood transfusion volume and higher mortality or lower survival rates. However, increased blood transfusion volume does not affect cancer recurrence in this case.
The researchers discussed how the inconsistencies between the results of cancer recurrence could be due to several factors. These factors include the doctor’s prognosis, the patient’s preoperative status, tumor stage and type, and the type of anesthesia used.
Esophageal Cancer
Collating several studies to have a general overview, scientists proceeded with a meta-analysis of esophageal cancer and blood transfusions. This 2018 systematic review included esophageal cancer studies from before February 2017. From all these, the researchers provided different conclusions.
One conclusion coincided with the previous two studies in that it supports the idea of high-volume blood transfusions reducing cancer survival. Specifically, 3 or more units of blood transfusion can significantly reduce esophageal cancer survival more than having 0 to 2 units.
The other conclusions include the greater survival rate in patients performing blood transfusions using their own blood than those using other people’s blood. The researchers also suggest that medical professionals should consider regulating the amount of blood transfusions for cancer surgeries.
Gastric Cancer
Another complication can present in this part of the body that is home to trillions of live and active bacteria. This complication is infection. Infection is another concern for surgeons because of the nature of the surgery itself, the environment, and the involvement of blood.
Knowing these factors, researchers performed a cohort study on 2,064 gastric cancer patients from 2010 to 2017. The study focuses on the effect of blood transfusion on infection through gastrectomy. It notes that the volume of blood transfusions, operation time, the number of organ resections, and BMI are all factors contributing to infection during a gastrectomy.
The researchers propose that the possibility of infection is due to excessive bleeding that can occur during surgeries. This can affect the patient’s immune system during and after the operation. Subsequently, this can also lead to anemia.
The Overview
Out of the four cancers discussed, one unifying idea is that the amount of blood used for transfusions can severely affect the patient’s mortality. There are several other factors to this, and the causes are not clear yet. However, the correlation still stands in recent studies.
Aside from the mortality rate, different complications can also arise from blood transfusions. The complications include infection and cancer recurrence. Although these can be specific to different cancers, one should still be alert and always consult your doctor regarding these complications.
