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Methotrexate and cancer risks

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Posted 6/29/2008 4:11 PM (GMT 0)
Good Afternoon everyone.

Ok..was just going to add to the other mtx post, but decided on a new one instead...hope you dont mind.

My problem is that after 4 months since starting this lovely drug, I still get the nausea, and now...a pain in my left side. Rheumy says its not my liver...but why do I feel so sick on this darn drug?  He offered to put me on injections, but my ins wont cover it..hmmm same drug, same dose, one is covered the other is not.

Well..I have heard rumors about mtx and cancer links, but paid no mind to it...till this morning when I got this email from an arthritis site I stumbled across.....I want to get off the mtx, I have alot of cancer in my family, and I do have alot of health issues...so........am I just being paranoid?  Like some of you here, my doc says to take 5 mg folic acid 2 days after my mtx dose too, and from some of the replies I saw to the other mtx post, I cant help wonder why some of our docs are not letting us take it daily?  here is that cancer warning I got this morning

http://arthritis.about.com/b/2008/06/22/rheumatoid-arthritis-drug-methotrexate-raises-cancer-risk.htm

Why cant we just get increased doses of the plaquinal instead of changing over to mtx I wonder?

Thanks for any help you can give.

Gentle hugs,

Diane

Posted 6/29/2008 6:36 PM (GMT 0)
Hey there Diane.. have you asked your doc these questions? If I where you, I'd voice my concerns over your family history and you taking MTX with him, and ask him if there is something you can take instead (i.e. increasing the plaquenil).. I take my folic acid daily, as well as a B complex vitamin.. even though I only take the MTX once a week.. I also double my dose of B complex vitamins and folic acid on the day I take the MTX as well as the day after.. so far, so good.. but if I don't double up, I'm horribly sick.. I forgot one night about my MTX and I had an alcoholic drink.. man, did I feel terrible the next day.. I will NEVER make that mistake again.... My rheumy didn't tell me when to take the folic acid or B complex, he just told me it would be beneficial for me to take it, so I have taken it upon myself to take it when I want.. and that's what has worked for me so far.. good luck to you, and let us know what your doctor says..
Posted 6/29/2008 7:04 PM (GMT 0)
My doctor approved me taking 3mgs of folic acid a day to counter the side effects of mtx. It supposedly does a great job with GI effects-I never had any so can't say for sure. The increased cancer risk is something i would discuss with your doc-my doc isn't worried and she does blood tests every 6 weeks for liver problems.
You did not mention what dose of plaq you are on but I take the max recommended dose 400 mgs a day-it was not enough for me I needed something else to get off the pred. Maybe you could talk to your doc about the biologics-but they work better with mtx. Plaq has its own risks espescially at higher doses but finding the right meds is something you and your doctor need to work out based on you individual risks, tolerence for those risks and general health. Good luck finding a combo that works that you can live with.
Sj
Posted 6/29/2008 9:09 PM (GMT 0)
Thank you Ducky and Sj for your replies

My doc took me off the plaquenal, and I take 5 mg folic acid once a week.  I have tried talking to him.  He is a new rheumy for me, and I am starting to have alot of doubts about him.  I told him about my severe nausea, and the pain in my side...he looked at his computer and said my liver tests were great.....however, he said nothing about increasing my folic acid.  I had forgotten to get my work done for a long time, because I have a horrid time with my memory due to fibro.  So..once I got home, I realized that I hadnt had work done in ages.  Now I'm scared to phone his office to tell them I havent had blood work done in months...he will look incompetent, and I will look like a fool.

He has sucessfully got me off the prednisone after a 4 yrs battle to achieve that!!  I just dont know why he insists on the MTX, my pericarditis episodes (2 of them) were NOT from my RA directly, it was from shock.  He knows my family history, but insists on the MTX...and NO pain relievers either...

I am so worried now, it's very hard to find rhuemy's up here where I live.  THey are usually hours away. 

DUcky, I am terrified to even take a glass of wine...they say you can have 2 drinks a month if you insist on having any....I hate MTX skull    It makes living in this body horrible sad   but I cant quit it, because I am very sure he will NOT re-prescribe me the plaquinal....grrr what a mess...

I was gone for a long time from the forum, cuz my computer crashed at the beginning (I think) of Jan, and just recently got a new one.

Hope you are all having a lovely day

Forgot to answer you on the plaquinal Sj, I was on same dose as you...400 mg...and I felt fine on that.  Now I just feel like hell warmed over.   

Hugs

Diane

Posted 6/29/2008 9:39 PM (GMT 0)
I'm sorry your having such troubles and not liking being on the MTX. I would be a little afraid of taking it too.
I guess thats where I trust my doctors to know what is best and ok to take. What I have read about MTX,
I thought it was Chemo drug used with people with Cancer. So I'm not sure I understand why it would cause
cancer??? But now you got me a little worried about it. Hmm... I'm really new to it just started on it last
week so I don't know enough about it. But my GI know's how I feel about things and we're trying to get
me off the prednisone in hopes this works for me.
Posted 6/30/2008 12:11 AM (GMT 0)
Hi LBJ,

I'm sorry if this is causing you distress.  I think, if I read it right, it's when you are on low doses (not sure what they call low), and also family history, plus the fact that RA puts us all at risk for lymphoma (sp).  I honestly thought I would never get off the prednisone, but we got me down from 25 mg....to...tah dah!! ZERO, but it was just recently.  This is my second week with no prednisone, this is the first time since Dec 2003 when I was put on it...I am keeping my pinkies crossed.  This doc tapered it by 5 mg a day for 2 months...then 4 mg for 2 months, then 2 for 2 months, then 1, and now I am free of it.  I wish you lots and lots of patience and luck LBJ, takes a long time but it is so worth it to not have this drug in our systems.

Wishing you lots of luck,

Diane

Posted 6/30/2008 12:17 AM (GMT 0)
Paradoxically most chemo drugs increase the incidents of other forms of cancer. With mtx this risk is much lower than with most chemo drugs and specific to one type of lymphoma which often remits spontaneously if the mtx is discontinued. Each person has to decide for themselves what risks they are willing to accept but for me the quality of life I have from this drug and the ability to free myself from pred outweighed the slight elevation in cancer risk.
Sj
Posted 6/30/2008 2:16 AM (GMT 0)

I'm sorry you lost your plaquenil and I can't get by without it either and will have to soon go down to 200mg on my next visit, but I"m also on Enbrel.  It took me a long time to get used to the MTX and I take the folic acid every day.

My doctor  is really stingy with the pred but will give out pain meds if I am in severe pain.  I'm sorry you are not having good luck on the mtx.  I know for me the first time I was supposed to decrease my plaq, I didn't listen to my doctor becuase I couldn't get up my stairs, and I just told him I really needed it.  Also for the pain meds, I had to tell him my pain level was a 10 was on a scale of 1-10. I have been going there for almost 3 years and he finally listens to me.  

As far as the drinks, you can just not on the day of your dose, like Ducky said, it can make you really sick but a few days after or before it is usually not harmful.

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