The neighbor, Wu Da Ma, 65 years old, used to go to the nearby grocery store with her partner to buy groceries, but in recent months it seems to have become lazy, always want to lie in bed, no energy, reluctant to move. She thought she was old and didn’t think much of it. This day in the field to work in the daughter of Wu Da Ma happened to come back to see their parents, see the mother’s face is not good, the lips are a little pale, the palms are not as rosy as their own. The company’s main business is to provide a wide range of products and services to its customers. The actual fact is that you can find a lot of people who are not able to get a lot of money. Older women, who have been menopausal for a long time, do not have gynecological blood loss problems. There was no obvious bleeding, so why was she anemic? The routine blood test suggests that it may be iron deficiency anemia, which requires a blood test for iron metabolism and a fecal occult blood test. The actual results of the test are quite normal and there is no bleeding hemorrhoids, if you really find blood in the stool you would have come to see. The results of the laboratory tests suggest that Wu’s body is indeed iron deficient, and two of the three stool occult blood were positive. The actual fact is that the actual person is not a person who is not a person. When I heard that Ms. Wu was found to have stomach cancer, I got nervous. The next day, he also went to the hospital, and sure enough, he was also anemic, and the doctor told him to be hospitalized for examination. The bone marrow examination suggested that a tumor had metastasized into the bone marrow, and further examination revealed a 2cm-sized mass in the lower lobe of the right lung, which was clinically considered to be a bone marrow metastasis of lung cancer. Wan Liping of the Department of Hematology of Shanghai First People’s Hospital has three cellular components in blood: red blood cells, white blood cells and platelets. Among them, red blood cells contain hemoglobin, whose main function is to carry oxygen to various tissues and organs. Normal adult male hemoglobin is 120-160 g/L and female hemoglobin is 110-150 g/L. Men below 120 g/L, women below 110 g/L and pregnant women below 100 g/L are called anemic. Due to the decrease of hemoglobin, the blood supply and oxygen supply to the tissues and organs of the whole body including muscles and brain are insufficient, which can lead to symptoms such as fatigue, dizziness and tinnitus, memory loss, lack of concentration, panic and shortness of breath after activities, etc. Physical examination can reveal pallor of the mucous membrane of the mouth and lips, lid conjunctiva, palm of the hand and nail bed. Anemia is a symptom, not a disease name, and many diseases can cause anemia. Common causes in adolescents include intestinal parasites such as hookworms, iron deficiency anemia due to picky eating, and leukemia, which has a high incidence in adolescents, can lead to anemia; common causes in women of childbearing age include anemia due to excessive menstruation or blood loss during childbirth; common causes in the elderly include nutritional anemia and malignant tumors. In clinical practice, we often see some elderly people who have lost almost all their teeth and have not gotten dentures in time, have difficulty in eating, and drink porridge and eat pickles for a long time, resulting in insufficient intake of nutrients and anemia. This situation is relatively simple, and replenishing the missing nutrients can quickly correct the anemia. If there is no problem of malnutrition, then elderly people with anemia need to be alert to tumors. Some tumors themselves may have few symptoms and have anemia as the first manifestation. Iron deficiency anemia is often the first manifestation of gastrointestinal tumors, especially in men, postmenopausal women and the elderly. Long-term chronic blood loss due to tumor invasion of blood vessels in the wall of the gastrointestinal tract leads to anemia. After gastric bleeding, because hemoglobin forms iron sulfide through the action of intestinal sulfide, the stool is black tar-like; intestinal bleeding stool is usually dark red or bright red; while for small amount of gastrointestinal bleeding, the color of stool will not change, and the naked eye cannot identify whether there is bleeding or not, but it can be detected by occult blood test of stool. Secondly, there are also some malignant tumors that metastasize to the bone marrow causing anemia, which is already at an advanced stage of the tumor. There are also some tumors of bone marrow origin such as multiple myeloma and leukemia that also cause anemia, and blood and bone marrow tests can confirm the diagnosis. The symptoms of anemia caused by hemorrhage will be more obvious because the onset is rapid and the body cannot compensate in time. On the other hand, many tumors cause anemia more slowly, and due to the body’s compensation, there can be no symptoms in the early stage, and by the time the symptoms appear, the anemia is already very serious. Therefore, for the elderly, it is better to have a comprehensive physical examination regularly once a year, especially for tumor screening. Older people should not be careless and should go to the hospital in time when they have symptoms. They should not think that their symptoms are due to their old age, just like old man Zhang and old woman Wu, and they did not pay attention to them until they went to the hospital.