Saturday, June 28, 2008

Rheumatoid Arthritis Drug Boosts Melanoma Incidence

From Medicinenet.com

FRIDAY, June 20 (HealthDay News) — Rheumatoid arthritis (RA) patients treated with methotrexate have an increased incidence of melanoma and other cancers, an Australian study says.

Methotrexate (MTX) is a disease-modifying anti-rheumatic drug (DMARD) commonly prescribed to RA patients. A link between the drug and cancer has been suggested, and there are even concerns that the drug itself may be carcinogenic, but research examining this concern has proven inconclusive.

his new study included 459 RA patients (309 women, 150 men) who started treatment with MTX prior to June 1986. During a total of 4,273 person-years of follow up (an average of 9.3 years per patient), 87 cancers were identified.

The researchers found that the RA patients who received MTX were 50 percent more likely than people in the general population to develop cancer of any kind. In terms of specific cancers, the RA patients had more than a fivefold increased risk of non-Hodgkin lymphoma, a threefold increased risk of melanoma, and almost a threefold increased risk of lung cancer.

The increased risk levels for non-Hodgkin lymphoma and lung cancer were similar to the findings of studies in Europe and in the United States. However, the increased risk for melanoma identified in this study was new.



I've been on methotrexate since 1995, just so you all know. I knew about the increased cancer risk, but five-fold??? threefold??? 50% more likely than the rest of the world?

damn....

Lately the systemic risks associated with RA have been troubling me, even more than the RA itself. I had a routine health screen done in Feb and the cholesterol and triglyceride rates were high. I was able to bring down the cholesterol by half-heartedly dieting but the triglycerides continue to rise. Good news is that my fasting blood sugar was okay both times and I've always had low blood pressure -- even with the provigil, my blood pressure has risen to normal. However, my resting heart rate is a little fast.

People with RA DIE of heart disease. This post from last year freaked me out: Rheumatoid Death Rates Remain Unchanged. This quote bothered me: Because of the relationship between inflammation and rheumatoid arthritis and inflammation and cardiovascular risk, that may mean that "no matter what we do, we can't lower their mortality rate," Lindsey said.

"no matter what we do" keeps going around in my head.

I'm on day 5 of the South Beach Diet. I want to kill something, cover it in chocolate, and eat it while drinking a Dr. Pepper. I don't plan to be strict forever and I feel so silly shopping with my book in my hand. I'm very frustrated with the South Beach Site -- they charge $5 a week to be a member (except right now I'm taking advantage of my free 7 days). The site focuses on weight loss. Frustrating -- I don't care what size my jeans are. Okay, I care, but enough to make me want to try roasted eggplant -- I kid you not, I roasted an eggplant today. This is coming from me, who thinks a vegetable is yucky and the food pyramid consists of pop tarts, Dr. Pepper, and Baby Ruth bars.

I want to see if I can keep myself from having a heart attack in my 40s, from being one of those people who die of RA and its complications. There's a weight tracker on the site. What about a cholesterol tracker? Blood sugar tracker? Any indication whatsoever that the web site is designed to help people be healthy? Nope.

Lately, all of the studies in cardiology show the link between C-Reactive Protein and heart disease. C-Reactive Protein is a measure of inflammation. My current (former?) rheumatologist uses it to measure my RA progression. (Other docs have used SED rates). I'm want to get my last bloodwork from May and then compare my C-Reactive Protein levels between then and now. If eating all of this green stuff doesn't actually lower the inflammation in my body, then I think that South Beach might be a vain hope to stave off odds that it can't hope to touch.

If that's the case, if I'm going down on this on this boat, I'm going down with a Baby Ruth and Dr. Pepper, not a mixed green salad and a Diet Rite.

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