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Topic: New BC diagnosis with existing RA disease

Forum: Breast Cancer with Another Diagnosis or Comorbidity — Meet others who have breast cancer but also have another health diagnosis/comorbidity such as diabetes, MS, bipolar disorder, HIV or AIDS, Parkinson's Disorder, schizophrenia, etc.

Posted on: Aug 14, 2018 10:31AM

Whammyx2 wrote:

Is there anybody out there that has both breast cancer and a previous diagnosis of rheumatoid arthritis? I am just curious how doctors have developed a treatment plan or deal with these 2 conditions at once. I am not sure which disease to fear most.

I'm new to this website and I've recently been diagnosed with DCIS Stage 0 grade 3 breast cancer. I'll be going for a lumpectomy this week and have been told by my surgeon that because the cancer was caught in an early stage and it hasn't spread beyond the ducts that I will be needing radiation and hormone therapy. The pathology report showed that I was positive for both estrogen and progesterone receptors and was told that was a good ithing because it could be treated with hormone therapy. The medical oncologist said he would use Anastrazole in his treatment of the hormones even though he mentioned that it could cause joint pain. I've already had RA for several years now and can't imagine having to deal with any increased joint pain due to medication for treating breast cancer. For the past 6 years I've been on Methotrexate and Humira for my RA and when I messaged my rheumatologist letting him know of my new diagnosis he immediately replied that I would have to discontinue the Humira. I'll be see my rheumatologist next month to discuss his plan on how he will go about treating my RA now. I've started researching what having both these conditions might mean for an individual and it doesn't sound too reassuring. In the meantime, I was just wondering if there's anyone out there who has had to deal with these two conditions together at the same time?

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Aug 14, 2018 05:42PM - edited Aug 14, 2018 05:44PM by Golfnut33

hi whammyx2

Wow we are similar! I have DCIS stage 0 grade 3 >5cm. Already had a lumpectomy and have to have another to get clear margins then radiation. No hormone receptor status as BS doesn't believe it's relevant for DCIS. I also won't be having hormone therapy.

I have PSA and have been on methotrexate and Humira for 2 years. I did speak to my rheumatologist when I was initially diagnosed with ADH and he did also say that I would have to give up Humira if diagnosed with cancer - I'm not sure about his approach for DCIS but am seeing him in October so will continue with Humira until then.

I cannot imagine giving this up as I was in severe pain before and really for DCIS I would rather take my chances but I suspect I will have no say in the decision. I do however go to one of the leading specialists for PSA (psoriatic arthritis) so am really hoping he has some good options!!

Please keep me posted on your treatment plan.

I definitely fear the arthritis more but that’s just me ..

Dx 4/2018, LCIS/DCIS, Right, 6cm+, Stage 0, Grade 3
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Aug 14, 2018 10:36PM Whammyx2 wrote:

Hi Golfnut33,

I am so glad to hear from you. Based on what you shared it seems like you're just starting this BC journey as well. I'm sorry to hear that you have to go back for another lumpectomy to get clear margins. How long do you have to wait between surgeries? The breast surgeon that I have did warn me that that could happen to a patient but it sounded like it wasn't afrequent occurance. I'll be having my lumpectomy in just a few days and I'm already stressed because I can't take ibuprofen now and the pain is building especially with making walking miserable. I'm recovering from a total knee replacement that I had a couple of months ago so I still have some inflammation from that as well.

I had my first meeting with all my doctors last week to hear what kind of plan they all decided for me based on the mammogram and pathology reports. The team consisted of the breast surgeon, medical oncologist, and radiologist. I had left encouraged hearing that the cancer was in the earliest stage and apparently noninvasive at the present time.The medical oncologist informed me that he could use a drug called Anastrozole to block the estrogen and progesterone receptors, so that was the good news. The bad news was that one of the side effects of this drug is that it causes joint pain. I am not eager to hear this news and will consult with my trusted rheumatologist next month.

I have discontinued my Humira but still take methotrexate and the folic acid. I'm okay with giving up the Humira if he thinks that that had contributed breast cancer but I wonder if he'll have anything in its place to offer. Like you, I worry about the effects of giving up Humira up will have on my body. I have so much chronic pain most days that I no longer can enjoy going for walks or other activities that I enjoyed doing on a regular basis. Because our arthritic diseases are not curable but hopefully controlled with medication, we can only hope that a plan can be formulated to work together to control these conditions. Is ADH another medical condition that you need a special doctor for?

Just looking ahead to the radiation aspect of treatment for this DCIS, are you concerned about being a methotrexate and having radiation to skin that can burn more severely because of this medication? I'm discovering that there is so much to think about with this new diagnosis and many questions pop up as I read about other people's experiences.

Please keep me posted on how you are progressing. Best of luck with your next lumpectomy.

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Jan 11, 2019 08:22AM - edited Jan 11, 2019 10:12PM by Labmom82

I was diagnosed in October with IDC Stage 1. I have had RA for 15 years and tried many meds and most cause me stomach issues and the only thing that really works well for me is Enbrel. I have been off it since the diagnosis and only on the dreaded prednisone. I am flaring pretty much daily. It is out of control. The steroid shot only helps for a day or two. I just started radiation yesterday and my treatment is 20 visits so 4 weeks. They will not put me on any other RA meds until it is completed and they are discussing whether I can go back on Enbrel or not. Have any of you been able to go back on your biologics?

Dx 10/18/2018, IDC, Right, <1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 11/26/2018 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 1/10/2019 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jan 14, 2019 08:55PM Whammyx2 wrote:

Hi Labmom82,

I was on Humira for about 5 years but was taken off as soon as I told my Rheumatologist about my BC. I wasn't too upset at the time because I was trying to tell him that I didn't think it was working as well as before but my lab tests were normal he said I should continue. I was also on Methotrexate also and was told to continue just with that with a slight dosage increase. I went through 20 weeks of radiation but had a quit Methotrexate as well because there can be increased burning while on it. I finished my treatments in October and went back on MTX afterward but I was flaring more in neck, shoulders, knees. feet and ankles. My RA doc didn't offer Prednisone because probably because of a recent total knee replacement and risking infection. All I know is that being off my biologic for 3 weeks for surgery and then off MTX for a month for radiation helped to increase widespread pain issues. A few weeks ago I was put on a DMARD medication called Leflunomide to trial that until I see him in 3 months. About the same time I started taking Turmeric because of it anti inflammatory properties (I cleared it with my RA doc first) but I can't tell much of a difference yet. I was told it could take up to 3 months to feel any effects of the Leflunomide. I would take Ibuprofen sparingly for pain but after read the drug information I am afraid to.

I sometimes get discouraged because of the pain issues and how RA has changed my life and then have that compounded with a BC diagnosis besides. This site has so much information and support regarding breast cancer but it is difficult to find much on the internet regarding both diseases together and what to expect.

I wish you well with you radiation treatments and hope your doctor gets you off the Prednisone soon and maybe offer another solution. I, like you,dread being on prednisone but sometimes it is needed and it helps get thru the difficult days.

How is Tamoxifen working out for you? I was offered Armidex at first but didn't want to start that after reading about the joint and muscle pains side effects and many comments on the forum here. Then my MO offered Tamoxifen but that scares me as well. I did see an article that it could be effective at a lower dose so I may approach him about it next visit. I am very cautious right now with meds.

Let me know how your treatments goes.

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Jan 16, 2019 01:05PM Labmom82 wrote:

Hi Whammyx2. Most of the time my RA has been pretty well controlled with Enbrel with occasional flare ups when I over do things. In 2016, it was so controlled I only had to take it every other week. 2017 hit and the RA went crazy about the same time I started having chronic GERD and sinusitis/postnasal drip. Still suffering with both of those issues as well. The constant pain daily is wearing on me on top of the BC diagnosis. It goes from my shoulders, hands/wrists and knees/feet/hips in a matter of hours or days. I don't think I have had one full day without something flaring up since I stopped the Enbrel. I got zero sleep last night because my shoulder is flaring and I can't move it. (Which radiation will be interesting today having to put my arm above my head. They will have to move it for me while I just scream a little LOL). Something has got to give soon. I am not certain I can go over three more weeks on the dose of prednisone I am on. I hate bumping it up because that means longer time to get off it as you have to taper off. I haven't found anything yet that shows me I shouldn't take the Enbrel once I complete radiation. MO thinks I will be able to but also thinks I should try rituximab but I am not sure I want to.

As far as Tamoxifen, I won't start that until I complete radiation. I hate meds in general and my body is very sensitive to them so I tend to get lots of the side effects which makes me more cautious.

Dx 10/18/2018, IDC, Right, <1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 11/26/2018 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 1/10/2019 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jan 16, 2019 01:20PM kcrd4766 wrote:

Sorry to hear you are feeling so discouraged. You may also want to consider the absorption of turmeric (and all supplements). A hydro-soluble formula absorbs better.

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Jan 28, 2019 08:37PM candy-678 wrote:

Just wanting to hear how others with cancer and RA manage the pain.  And do their MO and rheumatologist discuss the treatment plan.  My PCP told me the MO and rheumatologist need to talk, but I know they don't.  My rheumatologist stopped the med when I was diagnosed with the cancer and started cancer treatments.  I am on nothing for the RA now.  I have mets in liver and bone.  With the bone mets, RA, and use of A/I's I have a lot of pain.  All I use is Tylenol.  Seems we are in a stalemate.  The rheumatologist wants to use methotrexate and the MO says no.  Any advise? 

Found mets on CT for unrelated issue. I only had 2 treatments with IV chemo, then switched to hormone therapy/targeted therapy. Also using Xgeva injections for bone mets Dx 6/2017, ILC/IDC, Left, 3cm, Stage IIB, Grade 3, 0/1 nodes, ER+/PR+, HER2- Dx 9/2017, ILC/IDC, Stage IV, metastasized to bone/liver, 0/1 nodes, ER+/PR+, HER2- Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole), Zoladex (goserelin) Chemotherapy AC Surgery Lymph node removal: Sentinel; Mastectomy: Left
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Jan 29, 2019 04:51PM Whammyx2 wrote:

Hi Candy,

I am sorry to hear of your pain issues and the lack of communication between your doctors. I am curious why your MO said no to MTX. My situation is different from yours in that I am not on hormone therapy and my MO said being on MTX would be okay for me. If your MO said not to use MTX than he should call your RA doc to explain why you shouldn't be on that medication and they should find what else might work instead. Your MO is the one wanting to discontinue your RA med but needs to talk with that doctor to find out what they might be able to offer you instead to keep you from going into a flare and to manage daily pain issues. I would encourage you to talk with your MO again and tell him you would like him to call you RA doc because you are suffering in pain because you are not on any RA meds. Or turn it around and have the RA doc call the MO, which ever might give you the outcome you need.

I was taken off my biologic when diagnosed with BC but left on Methotrexate. I was worried what that would do to my so when I had my first multidisciplinary meeting with my cancer doctors, I mentioned to each of them individually that I wanted to them to keep my RA doc in the loop. It was important to me because I didn't want to have my RA get out of control.

When I met with the RO for the first time I mentioned my concern about starting radiation while on MTX. He agreed that I should be off it during treatment. I asked that he contact my RA doc to discuss it with him and he agreed. The day before I was to start radiation I asked the nurse to speak to the RO to see what was decided. She went to talk with him and came back to say that he talked with my RA and they agreed that I should be off MTX while getting treatment. The problem was that neither of them got back to me to let me know, so I had taken my weekly dose a couple of days earlier. So in this case they communicated among themselves but left me out of the loop! I went back on the MTX after radiation but when saw my RA doc for a checkup and complained that I had widespread pain he discussed increasing my MTX to a point where I would go from pill to injectable form because of possible stomach/liver issues that could develop. I wasn't too keen on that idea so the next time I saw him he offered Arava to see if that might relieve my pain. This meant the I would stop the MTX because you can't be on both at the same time. I was told that it takes up to 3 months to feel the effects. It has been 6 weeks now and I have felt better for the was few days and am hopeful that maybe the Arava is working now for me but need more time to really decide if that is the case or not. I really blame my flare on the absence of RA meds and I am thankful that my Rheumatologist is willing to try something new. I don't see my MO much because I refused to go on Anastrazole that he chose for me because of the pain side effects that I have read about so he really doesn't have much to say about my RA drugs except that MTX should be good. On the other hand my RA doc agreed that Anastrazole can cause joint pain, but he didn't say if I should go on it or not.

I wish you nothing but the best and hope you get some relief soon. Keep us posted on what you decide to do.

Blessings to you.

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Feb 1, 2019 09:57AM candy-678 wrote:

Whammy-  I was on Plaquenil before the cancer diagnosis.  When we found the cancer ( we thought Stage 2 ) and started IV chemo we stopped the Plaquenil.  Thinking it was only during the months I would be receiving IV chemo treatments.     Then we found the Stage 4.  The RA was the least of my concerns.  Since I am now on Ibrance long term we have revisited the RA issues.  The Ibrance causes constant low white counts and immunosuppression.  My rheumatologist suggested Arava or methotrexate use, but the MO said NO to the Arava and if we tried methotrexate it would be iffy because it too lowers the white count and causes immunosuppression.   Could be dangerous.  Also, my thoughts are that a person is on the RA meds to slow progression of joint damage and, to be truthful, I have Stage 4, so how long do I really have?   I really don't want to use a biologic since they have been known to CAUSE some cancers and could they SPEED UP my progression of the mets?         The pain from the RA does bother me, so I am looking at the pain issue vs the actual joint damage issue.   I have not made another appt with the rheumatologist to discuss all of this and the pain concerns.   I just think he will say, " Well I recommend methotrexate and if you don't want that. there is nothing else I can do". 

Found mets on CT for unrelated issue. I only had 2 treatments with IV chemo, then switched to hormone therapy/targeted therapy. Also using Xgeva injections for bone mets Dx 6/2017, ILC/IDC, Left, 3cm, Stage IIB, Grade 3, 0/1 nodes, ER+/PR+, HER2- Dx 9/2017, ILC/IDC, Stage IV, metastasized to bone/liver, 0/1 nodes, ER+/PR+, HER2- Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole), Zoladex (goserelin) Chemotherapy AC Surgery Lymph node removal: Sentinel; Mastectomy: Left
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Feb 1, 2019 01:04PM Whammyx2 wrote:


I agree with you that these two experts in their fields need to talk to find out what would be the best treatment for you. I think it would be a good idea to make the appt with the rheumatologist to discuss the medication possibilities considering your present BC status. Update him (or her) as to what is happening with your BC and let him know that your pain has become an issue and you need to know what his recommendation is for control of RA pain. When he tells you what his recommendation is then ask him if he would please discuss this with the MO. Your doctors need to have a clear understanding what you want from them. I realize that sometimes some doctors are easier to talk with than others, but give it a shot and go in prepared to discuss what is important to you. You are right that you don't know how long you have, but being pain free is one goal to have.

Best wishes and be strong.Hug

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Feb 7, 2019 03:33PM Labmom82 wrote:

I had my final rad today and my RA flare ups have been so bad I cannot walk or raise my arms so my rheumy and mo talked and they have told me I could start back on Enbrel as early as tomorrow.

Dx 10/18/2018, IDC, Right, <1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 11/26/2018 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 1/10/2019 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 9, 2019 08:42AM Whammyx2 wrote:


Congratulations on finishing your radiation treatments despite your shoulder pain. It must have been difficult for you but somehow you made it through it all. I hope you get relief going back on Enbrel. It is nice that your doctors could agree to let you go go back on your RA medication. I wasn't allowed to go back on my biologic and instead got put back on a DMARD. I am not responding like I hoped I would but once I am on it for the initial 3 month period without problems, then I get bumped up in dosage. I am uneasy with being on RA meds and all its side effects but need to get the flares under control. Wishing you a speedy recovery.

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Mar 15, 2019 02:11PM Catob1969 wrote:

I have Psoriatic Arthritis (PsA) and am recently diagnosed with BC.

I have been on Humira for almost 5 years and have been prescribed methotrexate at different times when the flares were very bad.

I am scheduled to see the medical oncologist on the 27th to find out the results of my onco-type testing and his recommendation for chemo first to shrink the tumor or lumpectomy then radiation.

I have been fretting over the fact that I am on an immuno-suppressant and the newer immuno-therapy will not be an option for me. If that is the case I of course, start to worry about chemo itself and the side effects.

Am I understanding the options correctly when I read that immuno-therapy are contraindicated to a biologic and this most cases end up on chemo?

Anxiously awaiting more answers :)


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Apr 3, 2019 03:03PM Pommom1809 wrote:

I also have RA & was Dx with cancer in both breasts in September, 2018. My RA is mild flare ups are few & all I take is Plaquinel.

I took the plaquinel all through my chemo which I finished last Tuesday. Surgery is up next.


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