Can radiotherapy for cancer treatment cause lupus flare up?

[Dondees01]

My sister has lupus and has been diagnosed with breast cancer. Can the radiotherapy cause her lupus to flare up and us there anything she should be aware of before her treatment? Thank you

[maggielee]

Hi Dondees

So sorry to hear your sister has breast cancer, hopefully, your living (or she is) in a area with good cancer support, can't recommend enough to reach out for advise & support as there is such a wide variety of help out there. There are lots of therapies available for cancer patients too....

I couldn't find out the answer to this question, despite research & asking specialists when I was diagnosed with cancer. I wonder if the centres of excellence for lupus would know? Wish I thought of this .....

There is no joined up working in my area of the UK & I was handed from one doctor/nurse to another, never having a plan for dealing with all for all my diseases, etc.. & impact on one to another....

I had bowel cancer & I definitely flared with chemotherapy (post surgery) and I am still dealing with recovery, post surgery & chemo many months later.

I noted that healing is slower, as I was on MMF & hydroxy and my white blood count was very low which makes sense. Also, I was advised by my sjogrens specialist to temporary come off the MMF while on chemo as the chemo was going to 'zap' me & suppress my immunity anyway... If your sister is on immune suppressants you do need to discuss this with Oncology asap if she needs to continue during treatment or a rheumatologist?

The hospital will advise her of all sorts of possible side effects, etc. Just make sure she is aware that this kind of treatment (cancer) puts her in the extremely vulnerable group & she should be cautious about getting covid (and other infections) even with vaccinations. She may already be on the list and practice, like many of us, of avoiding others etc...still mostly isolating now.

I am taking MMF meds to suppress my autoimmune diseases & this was increased recently to see if this helps with ongoing fatigue & other physical problems & now i have been given a short/small dose of prednisolone to see if this helps with daily nausea, etc... First week & helpful.

Send her a hug from me... my sister is 10 years+ since being diagnosed a very aggressive breast cancer, wishing you & your sister my best healing thoughts..... ml

[KayHimm in reply to maggielee]

Maggie -

You might be interested that I read an article by an oncologist whose theory is that all cancer treatment causes an inflammatory state. He says that is why steroids work for the nausea. My radiation oncologist said he has seen people like me who get low grade fever due to inflammation the radiation causes.

I am not surprised the chemo caused a flare with you now that I read this guy’s theory. Your body did not the damage chemo did. I am very sorry you have had to deal with this on top of everything else.

Hope you get under better control soon. Yes, someone as complicated as you really does need to be at a tertiary care center.

[maggielee in reply to KayHimm]

Ta !!! Nice to have some confirmation, lock down & cancer are horrendous for talking/seeing folks.....let me if you have a reference to article....really good to know for dondee & me.... ml

[KayHimm in reply to maggielee]

Will get on it. My radiation oncologist said unequivocally radiation treatment causes inflammation. And he did not fight me about taking low dose steroids when I started running the low grade fevers. xk

[maggielee in reply to KayHimm]

👍Great...likr the feedbsck on radiotherapy...good to know....ml

[KayHimm in reply to maggielee]

He did say patients with autoimmune disease have more complications but that he had pulled patients through with more severe disease than I have and who are on lots of big meds.

It would be really serious if photosensitive patients couldn’t have radiation treatment, right? xk

[KayHimm in reply to maggielee]

Here is one (not the one I referred to): Inflammation and cancer-related fatigue: Mechanisms, contributing factors, and treatment implications. July 2012 Brain Behavior and Immunity

Will keep looking but this abstract gives you an idea how important a role inflammation is in cancer treatment.

Sorry I am not able to post link

[maggielee in reply to KayHimm]

Brilliant, will google away.....ml

[KayHimm]

I was recently diagnosed with anal cancer. Radiation is the mainstay of treatment. When I met with the radiation oncologist, he mentioned side effects and that with my fair skin I would likely burn. It didn’t hit me until two days later that “burn” may not go well with photosensitivity. I immediately left a message with my rheumatologist. He called the radiation oncologist and they agreed the radiotherapy was not contraindicated.

I think your sister will likely be told the same thing. The radiation is different from UV radiation. There are other issues that put your sister in a higher side effect risk but she she be watched very closely.

I actually did fine - much better than in fact. Hope that gives you encouragement.

She should be in touch with her rheumatologist. They may want to have the oncologist run extra tests on her because of her lupus.

Best of luck to you and your sister. We understand your worry.

k

[Minnie2000]

Hi Dondees, I'm glad you put this question on here as I have been googling the same question. I was diagnosed with breast cancer in May and have had 2 lots of surgeries (unfortunately the first one didn't get everything). I am now waiting to see the oncologist to discuss my upcoming radiotherapy plan. I'm just hoping that they are clued up on any lupus complications. Was considering ringing my rheumatologist for some additional advice. I've read about use of protective creams (R1 & R2 creams) and wondered if I would need something decent to protect me. Any further advice from anyone would be much appreciated. Wishing your sister all the best with this difficult journey. Much love. ❤️

[Dondees01 in reply to Minnie2000]

Hi Minnie, wishing you lots of luck with your radiotherapy

[KayHimm in reply to Minnie2000]

Minnie -

You should definitely let your rheumatologist know. As I mentioned before, my biggest scare was over photosensitivity. I feel certain you will be told that should not be an issue.

I did run low grade fevers with treatment. Both rheumatologist and radiation oncologist thought it could be inflammatory. I did fine, though overall.

The radiation oncologist will definitely know of any possible lupus complications. It is important to report any symptoms to the radiation oncologist. Don’t use anything without clearing it with the doctor first. They have special creams that are safe for radiation.

Lindie’s products are very good, particularly the cooling pads with aloe. But, again, make sure your doctor approves. My doctor told me the cooling pads were fine and he was going to look into them for future patient use.

Hope this was helpful

K

[Minnie2000 in reply to KayHimm]

Hi KayHimm, thanks for the message. That's really helpful. 🙂