This article discusses the connection between ankylosing spondylitis and cancer and how healthcare providers approach treatment when someone develops both.
Connection Between Ankylosing Spondylitis and Cancer
Ankylosing spondylitis develops when the joints in the spine become chronically inflamed. While many things can cause cancer, the chronic inflammation present in ankylosing spondylitis damages DNA, and over time, those changes can lead to cancer.
People with ankylosing spondylitis develop cancer at a rate of 256.3 people per 100,000 people. This increased risk isn’t associated with one cancer but many, such as:
Upper respiratory cancerDigestive cancersColon and rectum cancersLung cancerBone cancerConnective tissue cancersMelanoma and nonmelanoma skin cancersBreast cancerTesticular cancerProstate cancerUrinary bladder cancerKidney cancerBrain cancerThyroid cancerEndocrine cancersBlood cancer
Risks
The risk associated with cancer and ankylosing spondylitis has to do with inflammation and gene variations. There are several genes associated with the development of ankylosing spondylitis, including:
Cancers that affect the digestive tract and organs such as the colon, liver, and stomach Blood cancers such as multiple myeloma and lymphomaProstate cancer
HLA-B ERAP1IL1AIL23R
These genes play a role in immunity and how well the body fights off infection and disease. In people with ankylosing spondylitis, variations or changes to these genes trigger inflammation that causes the disease to develop. These same genes, namely HLA-B and ERAP1, also play their own role in developing many specific types of cancer, such as Hodgkin lymphoma.
People with ankylosing spondylitis are significantly less likely to beat cancer and more likely to develop cancer earlier in their lives than the general population. Certain medications, mainly biologics, may also increase the risk of cancer. Because they are often used as a treatment for ankylosing spondylitis, it adds to the risk of cancer.
Treatment and Management of Ankylosing Spondylitis With Cancer
When a person develops cancer when they already have ankylosing spondylitis, cancer treatments are the same as they would be without AS. Possible therapies are:
Surgery to remove tumorsRadiotherapyChemotherapyDrug therapy
Many treatments for ankylosing spondylitis involve using immunosuppressants, which are medications designed to hinder the action of the immune system. These medications are used in ankylosing spondylitis to try to curb inflammation.
If a person with ankylosing spondylitis has to undergo chemotherapy, it is recommended that all immunosuppressant medications be stopped until after remission. Drugs that decrease the action of the immune system can make chemotherapy less effective.
As with all types of cancer treatment, people should manage their health during their therapy by:
Eating a healthy and well-balanced meal Avoiding smoking, alcohol and other vices that could contribute to a worsened outcome Managing stress effectively Getting enough sleep Joining a support group for people with cancer for emotional support
The best thing a person with ankylosing spondylitis can do is monitor any changes in their health and get regular cancer screenings in the first three years following their diagnosis. That way, if cancer does develop, they will likely catch it as early as possible.
Prevention
It is difficult to reduce the risk of developing cancer if you have ankylosing spondylitis. However, you can reduce your overall risk by engaging in healthy lifestyle practices like stress management, quitting smoking, maintaining a healthy weight, and protecting your skin from harmful ultraviolet (UV) rays.
You can also increase your risk of finding any cancer that does develop early by participating in regular cancer screenings after being diagnosed with ankylosing spondylitis.
Summary
Changes in DNA and cell damage caused by ankylosing spondylitis can develop into several types of cancers, some of which are more common than others. Treating cancer often takes priority when a person develops cancer after being diagnosed with ankylosing spondylitis.
Unexplained weight lossFatigueFeverPainSkin changes
Any medications that can counteract cancer therapy, such as immunosuppressants, are typically stopped during cancer treatment. To ensure overall health while coping with the diseases, a person with both should be aware of factors that they can control.
A Word From Verywell
Knowing the risk of cancer after an ankylosing spondylitis diagnosis may seem like more bad news. However, it puts you in a good position to screen and monitor yourself for symptoms or signs of cancer before it spreads and becomes more dangerous. Fortunately, cancer treatments are becoming more and more effective.
