Psoriasis and Cancer: Does the Skin Condition or Its Treatment Raise Your Risk? | MyPsoriasisTeam

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Psoriasis and Cancer: Does the Skin Condition or Its Treatment Raise Your Risk?

Medically reviewed by Florentina Negoi, M.D.
Posted on March 12, 2024

“Psoriasis makes my body weak — does it cause cancer?” asked one member of MyPsoriasisTeam. Another said, “There’s a high risk of cancer in my family, and I don’t want to go on something that might make it worse. Can psoriasis treatments cause cancer?”

Being diagnosed with psoriasis can be overwhelming, and the last thing you want to worry about is whether it increases your cancer risk. Several MyPsoriasisTeam members have wondered if such a connection exists.

So, what’s the link between psoriasis and cancer? Here, we’ll discuss what the research says about whether the conditions are related. We’ll also share tips on which questions you can ask your dermatologist as you’re considering psoriasis treatment options.

Research on Cancer and Psoriasis

Some research indicates there may be a link between cancer and psoriasis. One review of scientific studies from JAMA Dermatology indicated that people with psoriasis may have an increased risk for:

  • Lymphoma
  • Nonmelanoma skin cancer (also called keratinocyte carcinoma)
  • Esophageal (throat) cancer
  • Liver cancer
  • Pancreatic cancer

Keep in mind, however, that an association doesn’t mean that psoriasis causes cancer. Some individuals with psoriasis may have other conditions or lifestyle habits that may be the underlying factors for increased cancer risk.

More studies are needed to determine whether cancer is definitively linked to psoriasis. Take a closer look at two of the cancers that may be connected to psoriasis below to get an idea of what the research says.

Lymphoma

Lymphoma is a type of cancer that starts in the lymphocytes (white blood cells) in your lymphatic system and affects your immune system. The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma. Cleveland Clinic estimates that about 89,000 people in the United States are diagnosed with this type of cancer each year.

Some studies indicate that having psoriasis may increase your risk of developing lymphoma. Therefore, it’s important to talk about cancer risk with your dermatology team if you’ve been diagnosed with psoriasis.

Nonmelanoma Skin Cancer

Nonmelanoma skin cancer is a relatively common type of cancer. The most frequently diagnosed types are basal cell carcinoma and squamous cell carcinoma. These two skin cancers make up 80 percent and 20 percent of nonmelanoma skin cancers, respectively.

The association between psoriasis and nonmelanoma skin cancer has been debated. In one meta-analysis (review of several studies), people with psoriasis had a higher chance of developing basal cell carcinoma. Another study, however, reported a 16 percent lower skin cancer risk for people with psoriasis when compared to those without psoriasis.

What’s Behind the Possible Association?

Scientists who have found a link attribute the potential increased incidence of cancer among people with psoriasis to the following factors:

  • The inflammatory nature of psoriasis means the person’s immune system is overactive and therefore increases cancer risk.
  • People with psoriasis undergo treatments and therapies that increase cancer risk.
  • People with psoriasis tend to have higher incidences of cancer-causing behaviors, such as smoking.

Chronic Inflammation and Cancer

There may also be a link between inflammation from psoriasis and the risk of cancer. Having persistent inflammation may damage a person’s DNA over time, and DNA damage often comes right before cancer.

The inflammation from psoriasis might make it easier for cancer to develop because it can make the body less able to fight off harmful changes in cells.

Other types of inflammatory diseases have also been associated with an increased risk for cancer. For example, irritable bowel syndrome (IBS) is associated with a greater risk of colorectal cancer. Doctors think the prolonged inflammation in the intestines from IBS creates an inflamed environment that promotes cancer growth.

Psoriasis Treatments and Cancer Risk

There are several treatment options for psoriasis, and some types carry higher risks for cancer. Always discuss the side effects and potential risks of any treatment you’re considering with your doctor.

Phototherapy and Skin Cancer

Phototherapy is common and uses ultraviolet (UV) light to treat mild to severe psoriasis. One type of phototherapy is called psoralen long-wave UV A radiation (PUVA). PUVA uses an oral drug, psoralen, in combination with UVA radiation to treat psoriasis. Typically, the psoralen is taken an hour before the UVA radiation. The light treatment is then prescribed for 12 to 15 weeks with doses two to three times per week. Ultraviolet B (UVB) light is particularly successful in treating psoriasis.

One study in the journal Cancers showed that people who had between 351 and 450 sessions were six times as likely to develop squamous cell carcinoma than those who had fewer than 50 PUVA sessions. People who underwent fewer than 150 sessions of therapy had a small chance of developing squamous cell carcinoma.

New studies show that people treated with PUVA might have a higher chance of getting melanoma. This risk seems to go up after about 15 years of starting PUVA treatment. People who have had at least 250 PUVA sessions seem to have the highest risk. In the latest study, researchers found that those who had at least 200 PUVA sessions had nearly three times the risk of getting melanoma, even after considering things like age and gender.

Cyclosporine

Cyclosporine is a type of immunosuppressive drug, which makes the immune system less reactive. It may be used to treat severe cases of psoriasis. Long-term use can increase the risk of nonmelanoma skin cancer and lymphoma.

Cyclosporine is also commonly used during organ transplant surgeries. Reducing the activity of the immune system helps the body to accept the new organ, instead of attacking it as something foreign. Typically, doctors will prescribe cyclosporine after trying other treatments like PUVA and retinoids (medications that come from vitamin A, used to treat skin conditions).

Methotrexate

Methotrexate is another immunosuppressive drug with anti-inflammatory effects. Similar to cyclosporine, methotrexate may also increase the risk of nonmelanoma skin cancer and lymphoma.

However, there’s more to the story when it comes to methotrexate and cancer risk. This disease-modifying antirheumatic drug (DMARD) may slow down the growth of cancer cells. Always weigh the risks and benefits of any new treatment with your doctor.

Biologics

Biologic drugs are made from living organisms that target the immune system to reduce inflammation and symptoms of the disease. Biologics have changed psoriasis treatment for the better. However, they can cause side effects, including infections or cancer. Because of this, before starting biologic therapy, people need to be fully evaluated and closely followed up after starting treatment.

Studies have shown that tumor necrosis factor (TNF)-alpha inhibitors, which help reduce swelling, might make it more likely for someone to get a type of cancer called non-Hodgkin lymphoma. Other medicines for psoriasis, called interleukin (IL)-12/23 inhibitors, which also help with swelling and skin symptoms, don’t seem to increase the risk of cancer. Doctors need to keep watching and studying these treatments over time to know how safe they are for people with psoriasis in the long run.

Questions To Ask Your Dermatologist

Remember that your dermatologist or primary care doctor is a wealth of knowledge. To make sure you’re informed of the treatment options, consider asking your dermatologist the following questions.

  • How long and how often should I take the medication and/or come in for treatment?
  • What are the risks and side effects?
  • How have other people with psoriasis handled these treatments?
  • Will this increase my cancer risk?

Keep the line of communication open with your doctor. Everyone reacts to treatment differently, and it’s important to find a path that’s best for you.

What Can You Do To Reduce Cancer Risk if You Have Psoriasis?

Lifestyle changes may have a positive impact on your overall health and reduce your risk of cancer. Adjustments that may help you manage psoriasis and reduce your risk for cancer include:

  • Eating a healthy diet
  • Minimizing stressors in your life
  • Getting restful sleep
  • Avoiding known risk factors, like smoking, alcohol consumption, exposure to sun, various chemicals
  • Maintaining a healthy weight

Discuss your cancer risk with your health care team to make sure you’re taking the right steps to reduce disease risk. Talking with your doctors about your cancer risk is crucial, especially when managing psoriasis. They can guide you in choosing treatments that balance effectiveness with safety, considering your overall health and risk factors. Regular check-ups and screenings are important too, as they can detect any health issues early when they’re often easier to treat.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 126,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Are you concerned about psoriasis and an increased risk of cancer? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on March 12, 2024
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    Florentina Negoi, M.D. attended the Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and is currently enrolled in a rheumatology training program at St. Mary Clinical Hospital. Learn more about her here.
    Amanda Studnicki, Ph.D. earned her Bachelor of Science in biomedical engineering from the University of Delaware in 2014 and a doctorate of philosophy from the University of Florida in 2023. Learn more about her here.

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