Cancer and RA

[Afoster]

Hi, I’m Ann. Three years ago I was diagnosed with RA. On methotrexate and other drugs to surpress the symptoms. I tried several biological drugs but none agreed. Unfortunately I was diagnosed with early onset of breast cancer in March this year. I had to receive surgery to remove the cancer. Therefore I had to stop all my RA drugs as it’s not advisable to take the medication during cancer treatment. Luckily I’ve caught it early so I’m ok . However my rheumatologist thinks I should go back on methotrexate, I am reluctant. I’m now off all drugs except painkillers. My joints are very sore and I’ve completely changed my diet and take several supplements per day. Has anyone any advise please?

[Hidden]

That's pretty awful for you Ann, sorry you ve been so unlucky. My mum's recovering from major cancer op; it must be so stressful. Is it drugs and recurrence you re worried about. Could your oncologist give you any advice on drugs so at least you ve got balanced expert opinion? We re not medically qualified obviously but wish you well whatever you decide. I can understand your concern. Hope one of them has time to sit and discuss with you x

[oldtimer]

It is usual to have concerns about whether particular actions you take - foods, medications, stress, etc will bring back a cancer. What is stopping you going on methotrexate? You need to look at the fear and discuss with the experts on breast cancer to see what evidence there is.

[nomoreheels]

Hiya Ann, welcome. Well you have had a time of it, I'm sorry, but pleased your cancer was caught early & are now recuperating. You do need to be starting some treatment as your joints are sore, I think you really need professional advice about restarting your MTX, it may be thought the better DMARD for you with your history. Unless it's something specific that you'd like to talk about, why you're reluctant to start it, if it's side effects you had, we can maybe help there. If you were on tablets previously you could maybe try injections, or increase folic acid if you were on low dose previously or any other tips those of us on MTX can share like drinking more water on MTX day. Let us know & we'll see how we can help.

The thing is some RD treatments may be out for you now, I think for some previous cancers anti-TNF's though I'm not clued up why other than they reduce the body's ability to protect itself from detecting cancer. So, you really need to follow the advice of your Rheumy, he should know or if not be able to consult your breast cancer team. There's no doubt a good balance diet helps but be careful with supplements, unless you've already done so I'd be checked for any deficiencies, it's best to know what is necessary & those which aren't. Your GP will help there, & run them by your Rheumy, we tend to think they always help but in RD that's not always the case. I take a prescribed calcium/Vitamin D tablet daily & 5mg folic acid every day except MTX day & buy omega 3 fish oil, that's all I need.

I hope you find it helpful being here, we have one or two members who will relate to your concerns & who I'm sure will be along if they can help in any way.

[tinlizzie]

Hi, so sorry you have been so unlucky, hope your BC treatment remains successful. It would be really helpful if your oncologist and rheumy could get together to discuss your ongoing treatment. I have been on MTX and several biologics for many years and developed malignant melanoma. They always ask about MTX and are not keen. All these drugs suppress the immune system. My rheumy prefers Rituximab which depletes the B cells, but it is for your specialists to decide the best way forward for you. Loads of luck.

[Afoster in reply to tinlizzie]

Hi , yes my rheumatologist told me the only risk with methotrexate is skin cancer. Well I’ve just lost my niece to that so I’m reluctant to take methotrexate for that reason. I’m lucky my other niece is an oncologist but she has basically said you have to decide the risks but to function better and get better quality of life go back on methotrexate! You see medical doctors will always advise on medication because they are trained to do just that. I’m facing a brick wall and the only way around it would be to take the medication, methotrexate. Knowing my luck skin cancer will be my next diagnosis 😩 I don’t know what to do. Thank you so much for your reply 🙏🏻

[Peterpiper1966 in reply to Afoster]

Hi I suffer with RA and initially started with methotrexate and was fine for 15 months however after that I cudnt stop coughing so saw consultant and he changed medication to salsalversine now and touch wood i seem OK. Only saying that as I don't think salsaversine causes skin cancer and maybe u cud ask ure consultant to start salsalversine in stead of methotrexate !!

[keeta in reply to Peterpiper1966]

Exactly the same with me.x

[Afoster in reply to Peterpiper1966]

Hi are you sure it’s called salsalversine? Google it but no results?

[nomoreheels in reply to Afoster]

I think it's sulfasalazine Ann, sometimes spelled sulphasalazine.

[BlightyFiveStar in reply to Afoster]

Hi there sorry to hear of your situation. I asked about cancer risks before starting MTX as there is a high incidence of various types in my family including my sister before she was 40. I had cared for my dad through terminal cancer also when he was still fairly young. So for me this is very much in my mind. I was told by brusque RA nurse that as I have RA this increases the risk of all types of cancer, in itself, due to the inflammatory process. She didn’t specifically point out skin cancer and I haven’t seen that listed as a particular risk of MTX. It became clear to me that in fact leaving my RA to rage uncontrolled was in itself a cancer risk and this made me consider the MTX as something which has a role in reducing that risk, by reducing inflammation so hopefully making an environment where it is less likely that cells malfunction and become cancerous. I do worry but it’s a case of managing the most pressing thing at the relevant moment so that I can live now as best as possible.

I don’t know if this is helpful but I do send you support and sympathy in navigating a complex situation. Perhaps the best thing any of us can do is try to listen to what our body is shouting loudest about at the moment and try to manage that bit. Then when that is a bit calmer you can see where you are with the next thing that comes up? Perhaps base a decision on facts you know now (RA flaring) rather than a possible future event that might not happen (like skin cancer).

Good luck and feel better. It is great that they caught the breast cancer early and it seems treatment was successful.

[Afoster in reply to BlightyFiveStar]

Thanks for the reply. It means so much to be able to chat with folks who know what your going through. This is the worst about family and friends, they try to understand but don’t. And I suppose it’s unfair to expect them to. 🙂

[Benbecula]

Hello Ann - I was diagnosed with RA 29 years ago and a year later had breast cancer. I had a mastectomy followed by chemotherapy. The chemotherapy drug was methotrexate and my RA symptoms faded into the background during that time. Afterwards my rheumatologist started me on methotrexate and I have been on it ever since, at varying dose levels. I now take it along with a biologic.

Just wanted you to know that I am still here, with a few aches and pains admittedly, but living a good life, so have faith in a future beyond your current situation. If the methotrexate was not causing you problems, perhaps you should consider re-starting it if your rheumatologist so advises. You can always have a re-think in the light of your progress, or lack of it.

Good luck, I hope all goes well for you.

[Afoster in reply to Benbecula]

Thank you so much for sharing your story. This has helped me decide to go back on methotrexate. I’m very sore now without it. My blood results for arthritis has went up from 3 to 30. I’m back to hardly being able to lift myself of the toilet. Your story has inspired me so thank you so much 😊

[Benbecula in reply to Afoster]

I hope you soon begin to see some improvement. Sending you good wishes. Let us all know how you get on.

[AgedCrone]

Hi Ann,

Of course everyone is different.....I had breast cancer & had surgery just after being diagnosed with RA & went on Mtx after my Radiotherapy finished ..no mention was made by my oncologist or my rheumatologist that there was any reason not to. You don't say if you have already had radiotherapy or chemo......maybe you should discuss Mtx with your oncologist as well as your rheumy?

I stayed on Mtx for seven years & am now taking RTX which is one of the Biologics I was told I could take after having had a cancer diagnosis.

What you must remember if you decide against Mtx is you will have no protection for your joints if you only take painkillers.

Hope you can get your rheumy & oncologist talking to each other .

[Pam-51]

Dear Ann,

I was diagnosed with RA in 1974 aged 23 and have been on methotrexate and prednisolone for over 30 years. In 2006 I too developed breast cancer and following R. mastectomy and chemotherapy started on Rituximab in 2008. At that time it was required that I recommence the metho in order to qualify for the Rituximab treatment, which I did though rather reluctantly as I had similar worries. I agreed to a reduced dose of methotrexate in order to receive the biologic I desperately needed when the RA returned with a vengeance after the effects of the chemo faded. The best treatment I have ever had for my RA is chemo! Though not to be recommended!

Ten years on the treatment continues with no recurrence of my cancer despite it being stage 3 involving lymph nodes. In my experience metho and the biologics are the only things which have provided some relief from the RA and slowed down the progression of the disease. Without such drugs damage to the joints is irreversible resulting in loss of function.

When I developed RA the available treatments were not good and consequently I and many others suffered severe joint damage requiring replacement surgery at a later date and disability. Please consider the advice of your Rheumatologist carefully and if still in doubt get a second opinion. With the modern day treatments this disease can be managed and you are fortunate to have the opportunity to control it.

So pleased your BC was caught early and I wish you well.

Pam

[gym4life]

I never took methotrexate because of the side effect of cancer being one. My injections work for me. I am not an advocate of lots of medicine. I do natural remedies and my favorites are tumeric and ginger. on a daily basis.

[Afoster in reply to gym4life]

I agree totally. I’ve known one girl in particular who uses only supplements and diet to control her ra which is now in remission. She also exercised regularly and has now become a fitness consultant. However she is in her thirties and was reasonably fit to start with. She advised me to stick to the supplements and diet and in time I’ll feel much better. Three months into this I look better and my gut is much better. I’m still on 5 mg steroids but the pain is coming back bad so I will have to go back on methotrexate. I can’t bare going back to this pain. Thanks for your reply 🙏🏻

[Hessie5]

Wishing you well on this journey. It shall work out for you stay positive. As said talking to your consultant and constant monitoring is crucial too. Stay strong. 😌

[E_2b]

Yes I have advice the same thing happened to me as happened you. I was very ill on methotrexate and the doctors said I had to stay on methotrexate and that I would get used to the side effects. Then I ended up in accident and emergency vomiting blood was hospitalized and needed blood transfusions.

The damage had been done and a year later I was diagnosed with stage 3 colon cancer and had half my large bowel removed, now the good news!! in that year I discovered I had an infected root canal and when I had same extracted I got better almost immediately. I also followed the road back foundations advice, it's low dose antibiotics, research rheumatoid arthritis and the infection connection. I'm doing very well now.

I refused chemotherapy after the operation and did weekly IV vitamin C

Best wishes