Managing Treatments

Autoimmune Disorders and Cancer: What’s the Connection?

If you have an autoimmune disorder and you're facing a cancer diagnosis, you don't have to pick one treatment over the other.

Doctors and researchers have increasingly recognized a connection between autoimmune disorders and cancer. In recent years, researchers found an association between 23 inflammatory and autoimmune diseases and cancer development, according to the journal Anticancer Research. These findings mean that individuals with autoimmune conditions may be at greater risk for developing cancer.

A study featured in JAMA Oncology found that 14 to 25 percent of lung cancer patients have an autoimmune disease. Researchers believe that, since the immune system is constantly activated, it may lead to chronic inflammation, which may promote the growth of cancer.

Since there’s a relationship between autoimmune disease and cancer, it’s important to understand how your autoimmune disease may affect your cancer treatment plan and vice versa.

What Are Autoimmune Disorders?

Your immune system is supposed to protect you. When it senses bacteria and viruses, it mobilizes an army of immune cells to ward off these foreign invaders. Yet, with autoimmune diseases, your immune system mistakenly attacks your own body.

Some diseases attack a single organ (think Type 1 diabetes, which destroys insulin-producing cells in the pancreas), while others affect specific systems of the body. For example, rheumatoid arthritis targets your joints, multiple sclerosis causes damage to nerve cells and affects the transmission between brain and body, and Crohn’s disease hones in on your gut. Others, like systemic lupus erythematosus, attack the whole body. Patients often experience pain, inflammation, fatigue, muscle aches and swelling.

Doctors aren’t sure why our bodies can turn on themselves. The National Institutes of Health estimates that around 23 million Americans have an autoimmune disease. While the overall prevalence of autoimmune disease is 4.5 percent, women are twice as likely to be diagnosed compared to men, according to Autoimmunity Reviews.

Currently, there is no cure. People with autoimmune disorders largely focus on managing their symptoms with medication, like anti-inflammatory drugs and steroids, and with lifestyle modifications like exercise, diet, sleep and stress management.

Autoimmune Disorders and Cancer Treatment

On the surface, cancer treatment and autoimmune treatment seem to be at odds with each other. Many cancer therapies attempt to rev up the immune system to battle the disease. Conversely, autoimmune treatments are often designed to reign in an unruly immune system in order to control symptoms. Are the two treatments compatible? What are the options for those with autoimmune disorders and cancer?

Your autoimmune disease doesn’t prohibit you from receiving cancer treatment. In fact, some cancer-fighting drugs like chemotherapy and biotherapy medication have been used to help manage symptoms related to autoimmune conditions like lupus. They can suppress the immune system so that it stops attacking your body.

While immunotherapy has become more popular, patients with autoimmune disease are generally excluded from this form of treatment. Doctors are concerned that activating the immune system to fight harder will wreak havoc on individuals with autoimmune conditions, causing unmanageable side effects and toxicity. While a recent study published in the Journal of Clinical Oncology found that patients with autoimmune disease can safely receive immunotherapy treatment, more research is needed.

If you have an autoimmune disorder, talk to your doctor and your cancer care team about the risks and benefits of various treatment options and how to best manage your symptoms as you undergo treatment.

UVA has resources for cancer patients with pre-existing conditions like autoimmune disorders. Talk to a doctor to find the right treatment for you.

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Christine Yu