Any connections?

[madambutterfly]

I have had Ra for approx 8yrs, had a few surgical procedures on left foot and ankle, been on MTX for the past 5yrs also sulfasalazine, meloxicam and all that comes with it. Have been plodding along, some times the pain is worse than others. In April I noticed a small lump in the corner of my right eye (canthus), any way to cut a long story short, I was diagnosed with Basel cell carcinoma, its not major thank god!! I an just wondering if there may be a connection? I have had the lump removed and the prognosis is good. I am not out to scare anyone. Thank you folks.

[earthwitch]

Basal cell carcinomas are actually fairly common and pretty much always related to sun exposure or repeated sunburn. It seems that skin cancers generally can be a bit more common in immunosuppressed people but they are more usually squamous cell carcinomas. Given the number of people I know who have had either BCC or SCC (or both) I wouldn't think it was particularly unusual to get either whether or not you had RA, particularly if you have had a reasonable amount of sun exposure (or UV exposure generally, which could come from the likes of sunbeds) and particularly if you had got to the point of repeated sunburns. Some countries are worse than others for it too - NZ and Australia in particular have extremely high levels of skin cancers because the ozone layer in the atmosphere over that part of the world is so thin that it lets through a lot more UV.

I found this link that describes things quite well skincancer.org/skin-cancer-...

I think also, its good to remember that even though basal cell and squamous cell cancers are called cancer, they really are not on the same level of aggression as other cancers and can be very easily dealt with (SCC dont even have to have surgery, but can be treated with freezing or ointments). Really good that you got onto yours quickly though, as that will definitely reduce the risk of any further skin cancers (as long as you use high factor sunscreens).

[madambutterfly in reply to earthwitch]

Hi Earthwitch, I have had the lump removed they can not be sure all is removed, Its difficult as its very close to my eye, next step is Radiotherapy, I have been informed re the procedure. I am pleased there is no connection.

I am due to see the plastic surgeon next week and I keep a close eye! my eye.

I am not keen on the sun and have never sunbathed or used a sun bed, but the consultant said that it was very common in people with Celtic background, but as a precaution I am now covering up with factor 50 and big sun glasses just in case.

Thank you for your reply.

[Braecoon]

I developed a lesion on my eye lid a year ago which did look like a classical 'rodent ulcer' (basal cell carcinoma). My sulfasalazine was stopped in May 2015 and the lesion which had grown and had also become infected disappeared within a month of being off medication. I was scheduled for opthamology appointment to investigate the lesion in June 2015. I did attend the appointment even though the lesion was completely gone. The opthamologist looked up sulfasalazine - she was shocked at all the interesting side effects including the range of skin rashes/eruptions. She concluded in my case record that this was a drug induced skin lesion - I was so relieved it wasn't cancer.

I presume that they carried out a biopsy to confirm it was a BCC? Did they perform MOH's surgery which is the gold standard for BCC's around the eye and tends to leave a good cosmetic finish? My Scottish health board does not offer MOH's surgery so I was prepared to go private to have this done. Hope you have a good recovery, keep us posted on your progress - lots of hugs and best wishes.

[shareasmile]

Anyone taking immunosuppressive drugs will be more susceptible to cancers of various kinds--skin cancer being one of them. People with a northern European ancestry and fair skinned people in particular have a higher incidence. I used to work for a MOHS doctor and have seen the removal of many cancerous lesions. In general, basal cell cancers are slow growing and less invasive although they won't go away on their own. When a BCC was by the eye, we removed it and then an occuloplastic surgeon would do the reconstruction. The lacrimal duct (tear duct) needs to be protected, if possible.

The squamous cell carcinoma is somewhat more concerning. It tends to be faster growing and if it is ignored and gets bigger than an American quarter, it has a greater chance of spreading internally.

Then there is melanona--don't mess around with that bad boy!

Anyone taking the drugs we take should be vigilant about any skin changes and see a dermatologist regularly.

[madambutterfly]

Thank you shareasmile, sorry I have taken so long to reply.

I had the MOHS treatment, I am having regular check ups, I was given info on radiotherapy, just in case, but all seems well, and I am keeping a very close eye.......

I have now been told that I may have to go on to Rituximab infusion, as this is the only way to help with my RA this is the only tnf I can have due to the carcinoma.

I am not looking forward to this, in fact I am dreading this. But hopefully its a way forward. Thank you again for your help.