Tuesday, July 19, 2011

Chemo and Lupus: FAQs

Wait, what? Why chemo?
            I know that I’ve written about chemo before, but I still get asked about it on a regular basis. And I realize that it’s even more confusing now that I’ve actually been diagnosed with malignant cancer. So, to lay it out clearly: surgery was enough to treat my cancer, and the chemo that I’m on has absolutely nothing to do with cancer. Instead I, and many others, take low-dose chemotherapy to treat my lupus.
As a side note, I’m using “chemo” or “chemotherapy” as it is used in the vernacular; the terms refer to medications that are traditionally given to cancer patients. (As opposed to the scientific use, in which any chemical used to treat a disease can be called a chemotherapeutic agent).

But lupus isn’t cancer, right?
            No, lupus is not cancer. Lupus can predispose a person to develop certain cancers, but it is not itself any form of cancer. So why do we take chemo? The answer is that we basically take it for the side-effects. When a cancer patient takes chemo, one of the side-effects of the treatment is that (s)he becomes very immunocompromised. The chemo “accidentally” kills cells in the immune system while killing cancer cells; it’s a form of chemical friendly fire. This is why cancer patients tend to be very careful about crowds, and will wear face-masks if necessary to avoid infections. Lupus patients, on the other hand, need our immune systems to be shut down, since the immune system is responsible for our disease.

How does chemo help treat lupus symptoms?
            What many people don’t realize is that chemo drugs generally don’t target any specific kind of cell. There are certainly exceptions, but most of the time the chemo is a wide-spectrum poison that kills any rapidly dividing/growing cells. Since many cancers grow much more quickly than most healthy tissue in the body,  this strategy can be highly successful in treating cancer. Unfortunately, cancerous cells aren’t the only quick-growing cells in the body, and other quickly growing cells will also be killed by chemo. The idea is to give a patient enough chemo to kill cancerous cells, but not so much that it kills the patient. As it turns out, the cells in the immune system are some of the most quickly growing cells in the body, so they are hit hard by chemo drugs. So for those of us whose immune systems are overactive, chemo can help kill off enough immune cells to help improve our symptoms.

Do lupus patients on chemo have the same side-effects?
            This really varies from person to person. In general, lupus patients take a lower dose of a chemo drug than a cancer patient would, so the side-effects tend to be less severe. That being said, yes, most of us experience some degree of nausea, headaches, mouth sores and often hair loss. The symptoms are there, but they aren’t (again, generally) as severe. Side-effects from chemo occur because other rapidly-dividing cells, such as the cells that line the mouth and GI tract, are killed. Chemo is not a very specific tool, which is why the approval of new, more targeted, lupus drugs is so exciting.

How long are lupus patients on chemo?
            Cancer patients are often given a defined schedule of chemo treatments. They may, for example, have to receive an infusion of chemo once every other week for two months. Lupus patients, on the other hand, very rarely have a defined schedule. We don’t get told to come in for two months. It is not uncommon for a patient to stay on a particular chemo drug until the body builds up resistance to it. So we don’t know how long we will be on chemo, but it’s likely to be months or even years. This is only possible because the dose given to lupus patients is significantly less than that given to cancer patients. 

8 comments:

  1. thanks for the information .. it all helps..i am just going through the process of may be going on the chemo .. this is clear information which i find helpful.
    Cheers
    Lee-Ann from Australia

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  2. I'm so happy when people tell me these posts are helpful. Do you have any remaining questions I could answer?

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  3. Hi, Ive been trying to find research around lupus and chemo. I have lupus spectrum disorder, pernicious anaemia, hypereosiniphillia, fibromyalgia and few other ailments. I am trying to convince my consultant to let me try chemotherapy. Have you got any advice, and any other articles or views on this matter.

    Laura from united kingdom

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    Replies
    1. What kind of articles are you looking for? If your consultant would be interested in scientific literature, I can find some articles for you. Otherwise, I recommend this as a basic overview of the most commonly used (for lupus) chemo drug in the USA:

      http://www.mayoclinic.com/health/drug-information/DR600919

      It's worth noting that the doses lupus patients take are much, much lower than those taken by cancer patients, so the side-effects generally are not as severe. With this drug in particular, a supplement of folic acid greatly reduces side-effects in lupus patients (I can personally attest to that!)

      I hope some of that helps.

      Sam

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    2. Thanks for spending the time to reply. I would love some articles if possible, but i will look at the information you have given me and discuss with my consultant. Many thanks

      Laura

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  4. I have a cousin that is suffering from lupus. Her doctor wants to put her on Chemo. I have some experience with Chemo due to my husband having cancer (leukemia and lymphoma)and going through 2 rounds of chemotherapy. The doctors didn't tell us that taking chemotherapy would open up the possibility others cancers.
    Because my cousin is a smoker, I am concerned that chemotherapy could be opening up other possibilities for cancer. Is it worth the price of the possibilities just for relief from Lupus?
    Wishing you all the very best...
    K2

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    Replies
    1. That's a question that only your sister and her doctor can answer, as only they know how severe her lupus is, and how badly it is damaging her body. That being said, the levels of chemo used for the treatment of lupus are much lower than those used for cancer. The increased risk of cancer from the chemo is therefore also smaller. But the risk does exist, and it really just depends on the balance of how bad the lupus is vs. how concerned your sister is about an increased risk of cancer. You are absolutely right to be worried about the fact that she also smokes...at this point she has multiple risk factors, and that's never good. But again, the severity of her lupus may warrant the risk. It's always a balance game with chemo.

      Sorry I can't give a more definite answer, but lupus is a pain in the neck that way.

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  5. maggie.danhakl@healthline.comAugust 30, 2014 at 4:40 AM

    Hi,

    Healthline just designed a virtual guide of the effects of chemotherapy on the body. You can see the infographic here: http://www.healthline.com/health/cancer/effects-on-body

    This is valuable med-reviewed information that can help a person understand the side effects they are experiencing from their chemo treatment. I thought this would be of interest to your audience, and I’m writing to see if you would include this as a resource on your page: http://www.samvslupus.com/2011/07/chemo-and-lupus-faqs.html

    If you do not believe this would be a good fit for a resource on your site, even sharing this on your social communities would be a great alternative to help get the word out.

    Thanks so much for taking the time to review. Please let me know your thoughts and if I can answer any questions for you.

    All the best,
    Maggie Danhakl • Assistant Marketing Manager
    p: 415-281-3124 f: 415-281-3199

    Healthline • The Power of Intelligent Health
    660 Third Street, San Francisco, CA 94107
    www.healthline.com | @Healthline | @HealthlineCorp

    About Us: corp.healthline.com

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