Rheumatoid Arthritis and Cancer Risk
Learn the link between cancer and the drugs used to treat RA.
By Timothy Gower
People with rheumatoid arthritis (RA), and some related inflammatory diseases, face the reality of a slightly increased risk for developing certain types of cancer. Over the years, some researchers have questioned whether commonly used inflammation-fighting medications – particularly biologics – might take some of the blame for a heightened cancer threat. However, growing evidence tells us that chronic inflammation is the primary link between RA and cancer.
Lymphoma and RA
Understanding Lymphoma Risk
Do RA Drugs Add to the Risk?
Early Biologics Studies and Cancer Risk
Early on, studies suggested that biologic users might have up to a three-fold increased risk for developing cancer, particularly lymphomas. However, more recent research appears to clear the medications. A 2016 study published in Annals of Rheumatic Diseases involving more than 15,000 RA patients who took a biologic found no increased risk for lymphoma.
How the View of Risks Changed
Until recently, doctors were reluctant to prescribe most biologics to RA patients who had cancer, either currently or in the past, out of concern that the drugs might awaken a dormant tumor or worsen an existing malignancy. But given the lack of evidence for any link between biologics and lymphoma, or any other form of cancer, doctors are backing away from that.
Other Cancer Risks
Lung Cancer: People with RA have an increased risk for lung cancer. Smoking tobacco is the obvious link between the two diseases, since the habit dramatically raises the risk for both. But research indicates that RA patients who smoke are about 40% more likely to develop lung cancer than smokers who don’t have RA, suggesting that chronic inflammation plays a role as well.
Skin Cancer: Both methotrexate and biologic drugs seem to slightly increase the risk for two forms of skin cancer, known as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). According to a 2016 study in the BMJ, taking a biologic raises the risk for SCC by 30%, though that’s still a relatively small concern: Treating 1,600 patients with biologics for a year would lead to just one additional case of SCC than would otherwise be expected. Both BCC and SCC are highly treatable; but if you take a biologic, wear sun block and report any moles or other skin irregularities to your doctor.
The Bottom Line
An increased risk for a serious disease, even if it’s small, needs to be considered when deciding to take any medication. But it’s important to remember that poorly controlled RA not only damages joints, but also raises the risk for heart disease and other threats. For many, the benefits of controlling rheumatoid arthritis far outweigh the risks of cancer.
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