MXT and Basal Cell skin cancer

[PaulaE]

Hello everyone.

Has anyone taking MXT gone on to develop any skin cancers please? My 86 year old mother has been taking MXT 20mg per week since she was diagnosed with RA three years ago and has recently developed 3 areas on her scalp one of which has been biopsied and results were BCC. It was removed and healed but has also recurred. The Dermatologist says it's due to MXT but when we saw the rHeumatology nurse and asked if mum should stop the MXT, the nurse said see what the dermatologist says. We are really not sure what to do now?

Thank you for any advice anyone can give us.

[BoneyC]

Sorry to hear about your mother, but I really hope it's not due to MTX. How can the dermatologist be so sure, when age must play a factor?

[PaulaE in reply to BoneyC]

That's a very good point BoneyC, thank you. I assumed lowered immunity status is what she was referring to. The GP also mentioned the same. Mum has her dermatology appointment Friday but with a nurse so it may just be removing it again and going on the waiting list for removal of the others she has. Appreciate your reply very much, thank you.

[helixhelix]

These are very common skin cancers, about 30% of white people will get them at some point in their life. So she may have got them anyway, it's impossible to tell. The important thing is to stay alert to recurrances.

I don't feel your rheumy nurse's response was helpful. You could write a note to your rheumy asking that the rheumy consult with the dermatologist amd decide between them the best course of action and treatment for your mother. It shouldn't be down to you to run back and forth between them.

[PaulaE in reply to helixhelix]

Thanks so much for replying and yes, that's very true. Always a challenge when more than one service is involved I think!

[bevlin]

I’ve been on MX8 for nearly twenty years, my elderly mum has been on it for far longer. We’ve both had skin cancers but I was under the impression it’s more to do with the fact that our immune system is compromised and I’ve been advised not to sunbathe and to wear factor 50 sun screen in my face and hands etc when exposed to the sun. No one had told me not to sunbathe when I was diagnosed with RA twenty years ago!

[PaulaE in reply to bevlin]

Thanks for getting back to me bevlin.....That's a long time to have been on MXT for your mum and I'm sorry you too have to do so. Do you mind me asking how old your mum was when she first started on the MXT and what dose she had to take too? Mum stays out of the sun, like you and, you are right,its the immunosuppressant thing that makes MXT more of a risk. I hope you don't have too many skin cancers going forward either! Wishing you well.

[Denise64 in reply to bevlin]

hi

I too only found out few weeks ago that I'm supposed to be wearing factor 50.

I'm totally shocked, I do wear organic factor 25 normally but my heath care at home nurse told me about this n not my rheumatiod nurse or consultant .

So this year going to be very different, bring out the factor 50.

xxx

[Bookworm55]

I had one removed last year but it was there before I started on max. No mention was made of a link but I was told to use factor 50 sunscreen. That is probably the advice given to everyone though.

[PaulaE in reply to Bookworm55]

Thanks ever so and sorry you had one too. Hopefully its the only one you will have and I hope all goes well on the medicines for you.

[Bookworm55 in reply to PaulaE]

Thank you.

[AgedCrone]

Hi Paula...I’m not as old as your mother...but getting there!

I took methotrexate for seven years- years after stopping it I had a BCC on my face which I had removed ...... my dermatologist said at that point there was no way it could be blamed on the methotrexate....it was more likely to be from sun exposure. Five years later, I haven’t had any further BCCs. I would add I have many 70+ friends who did not take Mtx who have had them.

From a personal point of view - comparing my quality of life on methotrexate ........ie mostly pain free.....if I had still been taking it I would’ve continued because although BCCs are a nuisance, they are easily removed.

So I’d speak to both your mother’s rheumatologist and her dermatologist and get their opinions -but more importantly what does your mother think? If she is well controlled on methotrexate I wonder what her thoughts are ?

[PaulaE in reply to AgedCrone]

Bless you and thanks for replying. I'll share with mum as it may help reassure her. I'm so pleased you haven't had any more! Do you mind me asking, why did you stop MXT in the end? Do you have to take other meds now for your RA?

[Simba1992]

BCC is more common among people over 65. Mtx does increase the risk as well. I think This way the risk for BCC is raised in your mother.Mtx dose also matters when calculating risks. Age does matter when we asses the risk for adverse effects of meds.

[PaulaE in reply to Simba1992]

Thank you Simba. I think mum is on a high dose for her age and it worries us a bit that she has now been on it for three years too so I assume the risk of side effects must get higher the longer you are on it and the older you get?

[Simba1992 in reply to PaulaE]

It seems that more may not be better when Mtx is concerned. It may be an idea to take up the dose with her rheumie. The more you take the more toxic. Perhaps your mom would get along with a lower dose? Here is some info that may help.

rheumnow.com/content/dsb-ma...

[PaulaE in reply to Simba1992]

Thank you again, Simba. I'm wondering the same as she still also has to take prednisolone albeit only 5mg.

[Simba1992 in reply to PaulaE]

Mtx together with low dose pred has shown to be more effective than Mtx alone and also decrease side effects. How long has your mom been on the pred?

[PaulaE in reply to Simba1992]

Been on both for three years now.

[Simba1992 in reply to PaulaE]

As the effect of Mtx+ pred is more effective than Mtx alone maybe even more an idea to take up Mtx dose with doc(?)

[Bbell]

Hi, I was diagnosed with RA 5 years ago. I am on Methotrexate and Hydroxychloroquine. Since being on these I have had 2 BCC removed, 1 on my nose and 1 on my upper arm. I now see Dermatologist every 6 months to check these and discuss any other skin concerns. Fingers crossed have beeb clear for 3+ years.

[PaulaE in reply to Bbell]

Ah, sorry to hear this Bbell. I think its a good thing you have regular checks. Wishing you well!

[Downtime]

I’ve had many BCC s removed, well more than 10. I am fair skinned and had a lot of sun when I was young. I’ve been on Mxt for 5 years and have only had one during that time. We had much discussion before I started a biologic last year as unfortunately it makes you even more susceptible as it’s more of an immune suppressant. Decided that the benefits outweigh the possible skin cancer risk which will no doubt occur again, and I was advised to just use high factor cream and take care.

Age definitely plays a part anyway. An 83 year old lady I know who doesn’t have RA has started getting them now simply due to her age and outdoor lifestyle.

[PaulaE in reply to Downtime]

Thanks so much for replying. I'm sure you are right about risks and benefits. So hard as I want everything to be better for mum and sometimes we cant have what we want of course....Hope you continue to be well.

[BigJazza]

BCC: Had them before MTX started, have them after (another removal operation next week. ) Dermatologist told me that it takes years for MTX to be a factor so 'keep taking the tablets.'