Wednesday, July 29, 2009

Behcet's and cancer

If you subscribe to this blog, you might have noticed a dropoff in my posts. I've been a little busy: A couple of months ago I was diagnosed with breast cancer (invasive ductal carcinoma), but thankfully it was caught early. After weeks of trying to juggle procedures/surgeries along with my full-time job and long commute, though, the stress level became ridiculous. I'm now on medical leave from work, undergoing daily radiation treatments (M-F) .

So, does having Behcet's increase your risk of developing cancer? Does it increase your risk of developing breast cancer? I was especially curious about that, since I'm aware of two other BD patients who've been treated for breast cancer in the last 2 years. If I conducted an online poll, there's a chance of uncovering some other women in the same situation, too.

Regardless, right now there's not much published research on BD and breast cancer -- or on BD and other cancers, either. Is my cancer related to having BD, or could it be due to the immunosuppressant meds that were prescribed for treatment years ago? Or is it due to my age? After all, I'm over 50, and women my age have a 1 in 8 chance of developing breast cancer anyway. I hope more research is done in this area.

Here are some excerpts from recent articles -- full copies of these articles can be ordered through PubMed, by asking your doctor, or by visiting a local medical library:

Behçet's disease associated with malignancies. Report of two cases and review of the literature.
Clin Exp Rheumatol. 2005 Jul-Aug;23(4 Suppl 38):S35-41.
Kaklamani VG, Tzonou A, Kaklamanis PG.

"We performed a MEDLINE search from 1970 through 2003, as well as a search in the proceedings of international conferences for cases of malignancies associated with Behçet's disease.
RESULTS: Two of our 128 patients (1.5%) with Behçet's disease were found to have solid tumors. One male had lung cancer and the other female had kidney cancer...In the world literature 112 cases of malignancies associated with Behçet's disease were found: Sixty five cases were of male patients and 46 of female with 1 case of unknown gender. The solid malignancies associated with Behçet's disease included cases of bladder, breast, uterus, thyroid and stomach cancer, whereas haematological malignancies included leukemia, myelodysplastic syndrome, lymphoma, multiple myeloma, Hodgkin's disease and lymphosarcoma. The treatment administered in these patients with their disease is also reported.
CONCLUSION: ...There is discrepancy in the world literature and the possibility of development of malignancies in Behçet's disease patients should not be ignored."
PMID: 16273762

Here's another report

Malignancy in Behçet's disease: a report of 13 cases and a review of the literature.
Clin Rheumatol. 2001;20(4):239-44.
Cengiz M, Altundag MK, Zorlu AF, Güllü IH, Ozyar E, Atahan IL.
Hacettepe University Faculty of Medicine, Ankara, Turkey.

"Between 1986 and1999, 400 patients were diagnosed as having BD in Hacettepe University Hospitals. Thirteen patients (3.25%) developed [cancer] within a median follow-up time of 9.8 years. Solid tumors were diagnosed in 10 patients and haematological or lymphoid malignancies in three. Surgery was performed in seven patients, whereas radiotherapy [radiation treatment] was applied in six, and chemotherapy in eight. A literature review revealed 27 cases of BD associated with malignancies, mostly lymphoid or haematological.

Ten of our cases were solid tumors, and to our knowledge most of these are the first reported cases of specific malignancies [occurring together] with BD. Treatment-related morbidities [complications] were wound infection ... in one patient (1/7) and [radiation]-related [problems] in three (3/6) patients in a median follow-up time of 2 years. Solid tumors in addition to lymphoid and haematological malignancies are also seen during the course of BD. Radiation therapy may cause severe late [problems] in the presence of BD. Chemotherapy and surgery are fairly safe for the treatment of malignancies in BD patients."
PMID: 11529628

If you're interested in doing some more research on your own, here are some abstracts that you might want to read:

1) Chargari C, Kirova YM, Fourquet A, Campana F.
Severe acute radiation-related skin toxicity in a breast cancer patient with Behçet's disease.
Radiother Oncol. 2009 Apr;91(1):139. Epub 2008 Nov 17.
PubMed PMID: 19014876. (no abstract available)

2) Kammori M, Tsuji E, Ogawa T, Takayoshi N, Kurabayashi R, Takubo K, Kaminishi M.
The pathological findings of vasculitis simultaneously occurring with carcinoma, invasive breast carcinoma in a patient with Behçet's disease.
Available online for free at:
Breast Cancer. 2006;13(4):378-81.
PubMed PMID: 17146167.

3) Soleto MJ, Marcos L.
Behçet's disease involving the breast.
Eur Radiol. 2002 Dec;12 Suppl 3:S98-S100. Epub 2002 Jun 19.
PubMed PMID: 12522614.

4) Dündar SV, Sivri B, Gököz A.
Vasculitis of breast in Behçet's disease--a case report.
Angiology. 1988 Oct;39(10):921-4.
PubMed PMID: 3177958.

5) Souabni L, Elleuch M, Amira C, Sellami S.
Malignant lymphoma of the tonsil in a patient with Behçet's disease.
Joint Bone Spine. 2008 Oct;75(5):616-8. Epub 2008 Sep 18.
PubMed PMID: 18804394.

6) Bozi E, Katoulis AC, Stavrianeas NG.
Association of Behcet's disease with hematologic malignancies.
Int J Dermatol. 2007 Mar;46(3):333-4. Review.
PubMed PMID: 17343601.

7) Ono Y, Yamada M, Kawamura T, Ito J, Kanayama S, Katayama Y, Okusawa E.
Central nervous system malignant lymphoma associated with Behcet's disease. Case report.
Neurol Med Chir (Tokyo). 2005 Nov;45(11):586-90.
PubMed PMID: 16308519.

8) Aessopos A, Alatzoglou K, Korovesis K, Tassiopoulos S, Lefakis G,Ismailou-Parassi A.
Renal pseudotumor simulating malignancy in a patient with Adamantiades-Behçet's disease: case report and review of the literature.
Am J Nephrol. 2000 May-Jun;20(3):217-21.
PubMed PMID: 10878405.

9) Pretorius ES, Hruban RH, Fishman EK.
Inflammatory pseudotumor of the terminal ileum mimicking malignancy in a patient with Behçet's disease. CT and pathological findings.
Clin Imaging. 1996 Jul-Sep;20(3):191-3.
PubMed PMID: 8877172.