Hello Mouse, I came across this and thought it might be of some interest to you..Take Care
Doruk Erkan, MD
Associate Attending Rheumatologist, Hospital for Special Surgery
Associate Professor of Medicine, Weill Cornell Medical College
Associate Physician-Scientist, Barbara Volcker Center for Women and Rheumatic Disease
Michael D. Lockshin, MD
Attending Rheumatologist, Hospital for Special Surgery
Professor of Medicine, Weill Cornell Medical College
Director, Barbara Volcker Center for Women and Rheumatic Disease
Introduction
If you have lupus and also have cancer, you are apt to receive misinformation about your treatment options. If you wish to undergo a cosmetic enhancement procedure, from Botox injections to breast enlargement, receiving misinformation is also quite likely.
This brief review provides some correct information -- but also acknowledges that very little solid science is available to answer many questions.
Radiation Treatment for Cancer
Lupus, as well as other systemic autoimmune illnesses such as rheumatoid arthritis or scleroderma, are chronic, lifelong diseases. Although not unusually susceptible to develop cancer, some patients with rheumatic diseases, in natural course of events, do develop other illnesses such as breast cancer. To the surprise of patients and their rheumatologists, rheumatic disease patients who develop cancer are often told that they cannot receive radiation therapy, breast reconstruction, or certain kinds of chemotherapy because of their disease. There is very little basis for these restrictions. Most papers on the topic do not show important complications resulting from radiation therapy in patients with systemic autoimmune diseases.(1, 2, 3, 4) A retrospective review published in 2008 speaks of a higher frequency (compared to patients without connective tissue diseases) of late complications - primarily intestinal perforation - in patients receiving radiation to the pelvis, possibly a result of long-term steroid and immunosuppressive therapy weakening this area.(5) However, in even this group of patients, the frequency of acute or late complications was low, and many factors that might have increased the complication rate could not be analyzed. Ironically, radiation therapy was once touted as a treatment for lupus, rheumatoid arthritis, and ankylosing spondylitis.(6, 7) Rarely used today, it was abandoned because of long-term toxicity of radiation, but it was effective. Since cancer treatment often involves chemotherapy, treatment of autoimmune illness with immunosuppressive drugs must be altered; generally the cancer chemotherapy also treats the lupus, so it is possible to withdraw most lupus treatment when a patient undergoes chemotherapy.
Chemotherapy regimens for cancer sometimes have to be modified for patients who have taken other chemotherapeutic agents for autoimmune disease, particularly cyclophosphamide. Aromatase inhibitors and other estrogen analogues usually cannot be used in patients with antiphospholipid antibodies since these agents are capable of inducing blood clotting, a considerable risk in such patients.
http://www.hss.edu/conditions_lupus-radiation-cosmetic-enhancement.asp
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