Bioloics and Risk for Cancer

The cancer risk continues, but we don't have numbers for 40 or 60 years out, because the drugs haven't been approved for that long.

The cancer risk from UC is lifelong, even with surgery if any portion of colonic tissue is left behind, so get your colonoscopies!

Don't you know everything increases your risk of cancer, from waking up in the morning *checkmark*, to having cereal and juice for breakfast *checkmark*, to even walking in the park with your puppy dog haha. Who knows what to believe about cancer risks, as one study says coffee reduces your risk of cancer, then the next morning there is a study that says the opposite.

Not to make light of our disease or the meds we are on, as having active uc inflammation increases our cancer risk, the immunosurpressants and biologics increase our cancer risk as well. Just know we are screened more often then your average person, due to our increased risk. I would hope that the risk tapers off if you no longer need the meds (had surgery or whatever) but I certainly have nothing to back that assertion up with.

Gary, there is some evidence that Remicade can be used to induce remission and get the colon in really good shape, then stop it and continue treating with mesalamine-based drugs. Lonie did this and is doing really well still.

Yes, Fruitgirl is correct. I took Remicade for a little over five years and my last two colonoscopies showed no ulcers...so my doc and I decided it best to get off the Remi and to switch over to mesalamines -- maintenance meds. Two years later and I'm still in remission and feeling fabulous. Knock on wood...heh. So yes, once the colon is healed...it's possible to get off the Remicade.

As for cancer; I am in the belief that it can come from anywhere as well. I live for today and happy that I feel so awesome. I am no fortune teller, so I can't know what tomorrow will bring and therefore I "try" not to worry about it. Notice I said try!

I'm not sure that the risk of cancer continues much beyond treatment. As I understand it, by turning down the immune system, it may not actively go after cancer cells or viruses that cause/ contribute to cancer. It is not carcinogenic in and of itself.

My GI claims that recent research indicates that patients can go off Remicade after about a two-year run and then be reintroduced to it in the future if need be.

 

It's good to keep light of it and laugh about it if you have to but I really wonder about my Mom's cancer. She's on Remicade to treat her RA and has been for a long time now. about 3 years ago she was diagnosed with breast cancer (and beat it thank goodness). It just makes me wonder since there is no cancer hardly at all on her side of the family and no breast cancer. These things do happen as a result of drugs and I think people should take it seriously. We have no idea what this crap is doing/have done to our insides.

I don't think anybody thinks cancer is something to laugh at or the risk involved in taking any medication. But on the other hand...the more you worry the worse it can be for your health. Not sure you can pinpoint the reason for cancer and why some get it and some don't -- kind of the same thing with any disease. Human body = no logic?

It wouldn't be wised to take biologics or Imuran if you have skin cancer in the family, correct? Just curious. I was on Imuran for 2 1/2 years, with family history of skin cancer. I devloped these little pin prick red dots on my skin also.

At tornado6 "Prolonged observation is needed to determine the long term effects of TNF antagonists on lymphoma risk."

"Long-term risk assessment requires observational studies"


Correct me if im wrong, but no where in those two studies say "The cancer risk continues" like you stated in your first post.

"Does the cancer risk go away the second the medicine is stopped? It must continue for some time. My point was more that we do not know how long."

Well there is evidence that the risk does go away.(From studies in one of my posts) I got the impression that because they cause a drop in White blood cells it makes you more prone to getting sick, infections and getting cancer. If you were to stop the medications your white blood cells would return to normal and of the general public. Hence the risk of cancer is gone. ie the cancer risk is drug induced. Discontinue the drug and the effect is gone. Just like how you can get liver problems because of alcohol and high body fat% which return to normal once you stop doing those things which cause the problem.

I would imagine they would have to advise you to monitor after the treatment. Well I would think you are still prone to getting cancer from your last dose of treatment which would show up at a later time. Hence to monitor after treatment.

At the end of the day I haven't seen any evidence to show the risk carries on after treatment. Only evidence that it does not.

Also the following

"

It is unclear how the risk of lymphoma changes when therapy is discontinued, and whether the risk is dose related. The studies included in our meta-analysis all continued to follow patients after azathioprine/6-MP were discontinued. If immunosuppression is the primary mechanism leading to lymphoma, it is plausible that the risk of lymphoma would return to normal after the medications are discontinued. To the extent that this is true, individual studies and our meta-analysis may have underestimated the risk of lymphoma during therapy with azathioprine/6-MP. Regardless, our estimates should remain valid for the long term follow up of patients treated with these medications.

Some patients in our studies were treated with very low doses of immunomodulators, below that often recommended as appropriate for treatment of IBD.

Since the degree of immunosuppression appears to be related to the risk of lymphoma, this would tend to bias our results toward underestimate of the relative risk of lymphoma associated with immunomodulator therapy at currently recommended doses."

Post Edited (Jessicaaa) : 6/10/2013 10:07:10 PM (GMT-6)

Tornado6 said...
The FDA warning states, "Be aware of the possibility and monitor for the emergence of malignancies during and after treatment with TNF blockers."

There have been cases where some developed it after discontinuing, but they took the medications a lot longer. Around the 10 year mark. I'd have to find the report that shows the percentage in developing cancer at certain year points. Just buried under a lot of crap in my bookmark.