Rheumatoid arthritis seems like an easy disease to manage today. After all, we have the revolutionary biologics. The RA biologics do help but what happens when you develop an infection or a cancer?
The year I was diagnosed with RA I was also diagnosed with two different cancers that required extensive treatment. As a result, my rheumatologist decided it was best not to use a biologic medication.
As my rheumatoid arthritis progressed and became difficult to treat, we agreed that a biologic medication was the only solution. She avoided the TNF inhibitors. In order to do so she had to get permission from my insurance company. Today she would also avoid the JAK inhibitors. Both classes can cause cancer.
Orencia worked the best. The first time it lasted ten months. The second time it lasted the same.
Cancer complicated my RA treatment. I developed a third cancer that was a complication from Tamoxifen, a drug used to treat my breast cancer. Again, my RA treatment was put on hold while I had robotic surgery, chemo and radiation.
My last cancer was four years ago. Treatment took most of 2018. Since then, I have had two serious infections. One took ten months plus surgery to heal. The other took intensive treatment over a summer.
Cancer and infections are done. I have been on Actemra for two months. I see it as starting to help. Time will tell. When you have rheumatoid arthritis, life is challenging. Although many are well managed, there are about a third of us who have complicated cases with no easy answers. We are still looking for our magic bullet.
Although the biologics are a game changer, they aren’t helpful when we have cancer or infections. Nor are they helpful for those of us who do not respond to them. Treatment for RA has come a long way, but as you can see it still has a long way to go.