Link Between Rheumatoid Arthritis And Cancer

Link Between Rheumatoid Arthritis And Cancer

Patients with rheumatoid arthritis (RA), a chronic inflammatory
autoimmune disease, have a high risk of death from disease - at least
double the risk of the general population, studies overwhelmingly
show. Evidence has been less clear on whether RA patients are
exceptionally vulnerable to dying from cancer.

The first study to investigate whether patients with RA who develop
cancer have a decreased rate of survival, featured in the March 2007
issue of Arthritis & Rheumatism, also examined the impact of rheumatic
disease on overall cancer incidence. Conducted by a team of
researchers in the United Kingdom, it focused on 2,105 patients with
recent onset inflammatory polyarthritis (IP). Over time, a large
proportion of new-onset IP cases evolve into RA, meeting the
diagnostic criteria of the American College of Rheumatology.

Researchers followed the IP patients over a 10-year period to detect
the occurrence of cancer. Among the group, they identified 123 cases
of cancer for analysis. These cases included bone, lung, breast,
prostate, urinary, colon, and brain cancers; cancers of the digestive,
respiratory, and central nervous systems; cancers of the blood cells
and cancerous tumors; but excluding non-melanotic skin cancers. Then,
they compared these rates with the rates of cancer in the general
population from the same geographic area, Norfolk, adjusting for
difference in age and sex. Overall, the incidence of cancer was not
increased in the IP subjects compared with the general population.
However, the risk of blood cell cancers was increased among the IP
sample, a finding researchers expected given the association between
RA and lymphoma.

The study also compared the number of deaths in patients with cancer
and inflammatory arthritis with that of cancer patients without a
history of inflammatory arthritis. The finding was striking: a 40
percent increase in mortality in patients who suffered both IP, or RA,
and cancer.

"The results of this study demonstrated that 5-year cancer survival in
patients with IP is substantially reduced in comparison with that in
the general population, even after adjusting for differences in age,
sex, and cancer site, whereas the overall cancer incidence does not
seem to be increased," observes Alan Silman, M.D., an epidemiologist
with the University of Manchester and the study's leading researcher.
Whether targeted cancer therapies could improve the survival rate for
RA patients remains a subject for further research.

###

Article: "Influence of Inflammatory Polyarthritis on Cancer Incidence
and Survival: Results from a Community-Based Prospective Study,"
Jarrod Franklin, Mark Lunt, Diane Bunn, Deborah Symmons, and Alan
Silman, Arthritis & Rheumatism, March 2007, (DOI: 10.1002/art.22430).

On Mar 7, 3:21 pm, "NICK" <CALIFORNIA_CH...@PEOPLEPC.COM> wrote:
> Link Between Rheumatoid Arthritis And Cancer

My "noticable" arthritis occured only after about 8 months of ADT
(lupron and casodex). I'd like to think I don't apply with these
criteria.

WSF

WhiteSoxFan wrote:

> My "noticable" arthritis occured only after about 8 months of ADT
> (lupron and casodex). I'd like to think I don't apply with these
> criteria.

Have you read the insert that comes with the drugs?
See one example below (CAPS mine for emphasis).
3/4 = a double dash - something was lost in cut-and-paste.

Lupron
Side Effects
Clinical Trials

In the majority of patients testosterone levels increased above
baseline during the first week, declining thereafter to baseline
levels or below by the end of the second week of treatment. This
transient increase was occasionally associated with a temporary
worsening of signs and symptoms, usually manifested by an increase in
bone pain (see WARNINGS section). In a few cases a temporary worsening
of existing hematuria and urinary tract obstruction occurred during
the first week. Temporary weakness and paresthesia of the lower limbs
have been reported in a few cases.

Potential exacerbations of signs and symptoms during the first few
weeks of treatment is a concern in patients with vertebral metastases
and/or urinary obstruction which, if aggravated, may lead to
neurological problems or increase the obstruction.

In a comparative trial of LUPRON INJECTION (leuprolide acetate) versus
DES, in 5% or more of the patients receiving either drug, the
following adverse reactions were reported to have a possible or
probable relationship to drug as ascribed by the treating physician.
Often, causality is difficult to assess in patients with metastatic
prostate cancer. Reactions considered not drug related are excluded.

In this same study, the following adverse reactions were reported in
less than 5% of the patients on LUPRON. Cardiovascular System¾ Angina,
Cardiac arrhythmias, Myocardial infarction, Pulmonary emboli;
Gastrointestinal System¾ Diarrhea, Dysphagia, Gastrointestinal
bleeding, Gastrointestinal disturbance, Peptic ulcer, Rectal polyps;
Endocrine System¾ Libido decrease, Thyroid enlargement;
Musculoskeletal System¾ Joint pain; Central/Peripheral Nervous System¾
Anxiety, Blurred vision, Lethargy, Memory disorder, Mood swings,
Nervousness, Numbness, Paresthesia, Peripheral neuropathy, Syncope/
blackouts, Taste disorders; Respiratory System¾ Cough, Pleural rub,
Pneumonia, Pulmonary fibrosis; Integumentary System¾ Carcinoma of skin/
ear, Dry skin, Ecchymosis, Hair loss, Itching, Local skin reactions,
Pigmentation, Skin lesions; Urogenital System¾ Bladder spasms,
Dysuria, Incontinence, Testicular pain, Urinary obstruction;
Miscellaneous¾ Depression, Diabetes, Fatigue, Fever/chills,
Hypoglycemia, Increased BUN, Increased calcium, Increased creatinine,
Infection/inflammation, Ophthalmologic disorders, Swelling (temporal
bone).

In an additional clinical trial and from long-term observation of both
studies, the following additional adverse events (excluding those
considered not drug related) were reported for patients receiving
LUPRON.

Cardiovascular System¾ Bradycardia, Carotid bruit, Extrasystole,
Palpitations, Perivascular cuffing (eyes), Ruptured aortic aneurysm,
Stroke, Tachycardia, Transient ischemic attack; Gastrointestinal
System¾Flatus, Dryness of mouth and throat, Hepatitis, Hepatomegaly,
Occult blood (rectal exam), Rectal fistula/erythema; Endocrine
System¾Libido increase, Thyroid nodule; Musculoskeletal System --
ANKYLOSING SPONDYLOSIS, ARTHRITIS, Blurred disc margins, Bone
fracture, Muscle stiffness, Muscle tenderness, Pelvic fibrosis, Spasms/
cramps; Central/Peripheral Nervous System¾Auditory hallucinations/
tinnitus, Decreased hearing, Decreased reflexes, Euphoria,
Hyperreflexia, Loss of smell, Motor deficiency; Respiratory
System¾Chest tightness, Decreased breathing sounds, Hemoptysis,
Pleuritic chest pain, Pulmonary infiltrate, Rales/rhonchi, Rhinitis,
Strep throat, Wheezing/bronchitis; Integumentary System¾Boil (pubic),
Bruises, Hives, Keratosis, Mole, Shingles, Spiders; Urogenital System¾
Blisters on penis, Inguinal hernia, Penile swelling, Post void
residual, Prostatic pain, Pyuria; Miscellaneous¾Abdominal distention,
Facial swelling/edema, Feet burning, Flu, Eyelid
growth,Hypoproteinemia, Accidental injury, Knee effusion, Mass,
Pallid, Sallow, Weakness.

Postmarketing

During postmarketing surveillance which includes other dosage forms
and other patient populations, the following adverse events were
reported.

Symptoms consistent with an anaphylactoid or asthmatic process have
been rarely (incidence rate of about 0.002%) reported. Rash,
urticaria, and photosensitivity reactions have also been reported.

Localized reactions including induration and abscess have been
reported at the site of injection.

Symptoms consistent with fibromyalgia (e.g., joint and muscle pain,
headaches, sleep disorders, gastrointestinal distress, and shortness
of breath) have been reported individually and collectively.

Cardiovascular System ¾ Hypotension; Gastrointestinal System ¾ Hepatic
dysfunction; Hemic and Lymphatic System ¾ Decreased WBC; Integumentary
System ¾ Hair growth; Central/Peripheral Nervous System ¾ Spinal
fracture/paralysis, Hearing disorder; Miscellaneous ¾ Hard nodule in
throat, Weight gain, Increased uric acid; Musculoskeletal System ¾
Tenosynovitis-like symptoms; Respiratory System ¾Respiratory
disorders.

CHANGES IN BONE DENSITY: Decreased bone density has been reported in
the medical literature in men who have had orchiectomy or who have
been treated with an LH-RH agonist analog. In a clinical trial, 25 men
with prostate cancer, 12 of whom had been treated previously with
leuprolide acetate for at least six months, underwent bone density
studies as a result of pain. The leuprolide-treated group had lower
bone density scores than the nontreated control group. IT CAN BE
ANTICIPATED THAT LONG PERIODS OF MEDICAL CASTRATION IN MEN WILL HAVE
EFFECTS ON BONE DENSITY.

Pituitary apoplexy: During post-marketing surveillance, rare cases of
pituitary apoplexy (a clinical syndrome secondary to infarction of the
pituitary gland) have been reported after the administration of
gonadotropin-releasing hormone agonists. In a majority of these cases,
a pituitary adenoma was diagnosed, with a majority of pituitary
apoplexy cases occurring within 2 weeks of the first dose, and some
within the first hour. In these cases, pituitary apoplexy has
presented as sudden headache, vomiting, visual changes,
ophthalmoplegia, altered mental status, and sometimes cardiovascular
collapse. Immediate medical attention has been required.

See other LUPRON DEPOT and LUPRON INJECTION package inserts for other
events reported in the same and different patient populations.