Do Psoriatic Arthritis types really cause cancer?

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Did you get it? If actually, the answer to this question is yes, what will you do? Well, let’s have a look. What does this mean? Psoriatic Arthritis(PsA) is an inflammatory disease in joints. It attacks 2%-3% of the population worldwide. This indicates how many people suffer from this. There are different types of psoriatic arthritis. PsA is not a life-threatening condition, but because of that certain disabilities may occur. Due to that, many people experience difficulties in their daily lives.

The connection between cancer and psoriatic arthritis types is becoming an interesting topic. Since many patients with PsA develop cancer in their lifetime, make this discussion. Why is this? Does PsA cause Cancer? Well, this is the place to clarify your problem.

 

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Is there any connection between Psoriasis and Psoriatic Arthritis types?

Psoriasis and Psoriatic Arthritis Types are actually like relatives. Psoriatic Arthritis (PsA) is a chronic disease. It remains for a long time. According to the definition of US National Center of Health Statistics, chronic disease is a disorder that lasts for 3 months or more. The specialty of PsA is, it is likely to have psoriasis. About, every one person develops psoriatic arthritis out of five patients with psoriasis. Psoriasis is a skin disease. This causes skin cells to multiply 10 times faster than normal cells. So, these extra cells build up on the skin and lead to various symptoms. For example,

  • Itching, scaly, dry, and cracked skin
  • Red patches on the skin
  • Thickened, ridged nails, etc.

Similarly, Psoriatic Arthritis types also have symptoms of arthritis. But specifically with psoriasis features. They are,

  • Swollen, tender joints (this can be one or both sides of your body)
  • Painful muscles
  • Morning stiffness
  • Fatigue
  • Scaly scalp

PsA has other names such as Arthropathic Psoriasis and Psoriatic Arthropathy. Furthermore, it is an autoimmune disease. Have you wondered what autoimmunity is? It means your immune system unnecessarily attacks your body cells. Studies identify 83 new cases of PsA, per 100,000 persons for a year worldwide (based on new studies). This can affect both men and women. Mostly, the disease appears at the age of 30-50. Of course but, this can be different. Some can develop PsA, even 10 years after psoriasis develops.

What are the types of psoriatic arthritis?

There are five major psoriatic arthritis types.

  1. Symmetrical polyarthritis
  2. Asymmetrical oligoarticular arthritis
  3. Distal interphalangeal arthropathy
  4. Arthritis mutilans
  5. Spondylitis with or without sacroiliitis

Besides, juvenile psoriatic arthritis is another type of Psoriatic Arthritis appearing in children.

Symmetrical polyarthritis and asymmetrical oligoarthritis are the most common types of psoriatic arthritis.

 

So, let’s have a closer look at how these types of psoriatic arthritis differ?

  • Symmetrical Polyarthritis

Symmetrical Polyarthritis has features of rheumatoid arthritis (RA). In general, it attacks the same joints on both sides of the body. RA also shows this pattern. For example, if you have psoriatic arthritis in your knee or hand on the right side of your body, you’ll feel the same symptoms from your left side also. Although it shows the same pattern, symmetrical polyarthritis is quite different from rheumatoid arthritis. It shows not only a mild form of RA but also has relative asymmetry.

  • Asymmetrical oligoarticular arthritis

This was one of the most common types of psoriatic arthritis in the past. First, the term oligoarticular means an arthritis condition that affects two or four joints during the development of the first six months. Secondly, asymmetry means it only affects one side of your body. Knee, hip, and one or several fingers are some of the sites where asymmetrical oligoarticular arthritis occurs. Fingers and toes get a sausage-like appearance.

  • Distal interphalangeal arthropathy

The significant feature of this type of PsA is the involvement of small joints of the fingers and toes (distal phalangeal joints). The main affected sites are the ends of the fingers and toes, which are close to the nails. Inflammation of the skin around the nails starts. Also, swelling at the end of the last bones of fingers happens. Those are more prominent features. This PsA type has similar characteristics to osteoarthritis, but of course, it differs in numerous ways. Although distal joint inflammation is a basic feature of psoriatic arthritis, this condition only occurs in a small population. Usually, this is more common in males.

Arthropathy means any disease condition in your joints. In this case, it is an inflammation. So, it is also an arthritis type.

  • Arthritis mutilans

Arthritis mutilans is a rare type of PsA. This causes only very few people. Although, some studies indicate this is also very common among arthritis patients. Arthritis mutilans can be severe also. In this type, bone degrading cells or osteoclasts first break down the bone tissue. Then release the stored minerals of the bones to blood. Finally, this causes degeneration of bones. Arthritis mutilans type often affects the small joints in the fingers and toes. Also, it may attack your lower back and neck causing pain in those areas. Identically, it causes you to have difficulty moving your joints.

  • Spondylitis with or without sacroiliitis

Spondylitis means the inflammation of your spinal bones. In this type of psoriatic arthritis, vertebrates of your spinal column inflammation and stiffness occur. There is an asymmetric pattern. The main sites are,

  • Neck – this is because the joint of the skull with the rest of the spinal column involves. You can feel the difficulty in moving your neck around.
  • Lower back – inflammation of the sacral region or the bones of your pelvis responsible for this pain. This inflammation indicates the term sacroiliitis. You may feel morning stiffness, even without getting any diagnosis using radiology. In general, it explains that the possibility of your doctor diagnosing you with the disorder may be difficult.
  • Spinal vertebrae
  • In addition, spondylitis may destroy your connective tissue. Thus, causing inflammation in your arms, hips, legs, and feet.

On the whole, this type of psoriatic arthritis leads to decreased movements around the above joints.  

Genetics and Psoriatic Arthritis types. What is the relationship?

 Psoriasis and psoriatic arthritis types have strong connections with genetic inheritance. Lots of studies conducted thus researchers have identified several genetic markers. They use different methods to find those genes. For example, familial analysis, segregation analysis, and linkage analysis, etc. Although the actual cause for the disorder is a mystery, variations of specific genes have many causal relationships. Environmental factors and several other exposures may have some influence on cause variations of the genes. The variations are similar to mutations.

Genes associated with PsA are genes of a family called Human Leukocyte Antigen(HLA).

  • CARD 14
  • HLA-B
  • HLA-DRB1
  • IL23R

The HLA genes are naturally really helpful. It supports the immune system to separate our proteins from foreign proteins. That is an essential protective mechanism of our immune system. The HLA-B gene is more likely to cause PsA, while the HLA-C gene causes psoriasis.

Other than the above genes, certain types of different genes are also responsible.

  • Tumor Necrosis Factor (TNF)
  • Major Histocompatibility Complex (MHC) Class 1
  • Interleukin (IL- 12 and IL-23) receptors

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How important is it to identify the familial inheritance in PsA?

You know already, there is clear evidence of inheritability in PsA. However, the inheritance pattern of PsA is unclear. As mentioned before, psoriatic arthritis is an autoimmune disease. Studies have shown that 40% of patients having either psoriasis or psoriatic arthritis have close relatives with the disease in their families. However, it seems not if you have those genes, you can exactly have PsA. It only increases the possibility. But the relationship between genetics and PsA is clear. It may be a valuable early indicator. Awareness of those factors may be really helpful if you have parents or siblings with psoriatic arthritis.

Many times, the identification of families inherited with those genes makes them safer. Because it enters those people to early examinations. Early diagnosis will help them to prepare for the future. They get proper knowledge about the condition. If you are insecure about this, you can contact your doctor and receive information.

Is there any connection between cancer and psoriatic arthritis?

Actually, for this question, the answer is still doubtful. Some researches show that there is no relation between these two, while some of them accept it as a yes. Cancer has become one of the major causes of death in today’s world. New cases and existing cases of cancer also increase rapidly. The common clue of both diseases is the genetic variations. As you know, Cancer and Psoriatic Arthritis both have a crucial inheritance of specific genes. Cancer and PsA are reasons for a lot of studies. Researchers are continuously trying to find any possible links between these two conditions. It is necessary to understand why? There are two suspecting reasons for developing cancer in psoriatic arthritis patients.

  1. First is the disease itself leads to systemic inflammation and causes variations in the DNA of body cells.
  2.  Second is the medications used to manage PsA, have some effect on causing cancer. For example, biologics and non-biological therapies.

What are the possible mechanisms of the development of cancer with PsA?

All Psoriatic Arthritis types are seronegative varieties. It means the patient is negative for the rheumatoid factor (RF). The exact mechanism of developing cancer with PsA is still unclear. Scientists show numerous possibilities of how Psoriatic Arthritis Types contribute to cancer development.

  • One aspect of the mechanism is as follows. Psoriatic Arthritis acts as a systemic disease. It attacks your whole body including blood. The inflammation places stress on blood cells, causing variations. Those variations or mutations ultimately lead to blood cancers. For example, lymphoma, and leukemia.
  • The other possible mechanism is considering each disease has its inflammatory pattern. By using these processes, autoimmune cells and autoantibodies induce changes in inflammatory proteins. Those are interleukin and Tumor Necrosis Factor (TNF). Some of these changed proteins can damage skin cells and some may be harmful to lung cells. This mechanism explains why having breast cancer with Psoriatic Arthritis but not with Rheumatoid Arthritis or Psoriasis.

Some researchers say that the risk of developing cancer is 64% higher in patients with psoriatic arthritis types than in the normal population. However, this also says if you manage your disease well, you may get much fewer negative results.

Therefore, disease management is a role model in preventing unwanted results.

Do DMARDs and biologics cause cancer?

Another question is, does the treatment for psoriatic arthritis types lead to cancer. Cancer makes you frightful. You may think, what is the advantage of getting medication for my disease, even though it may worsen my health. But, wait, this is also still a doubt.

DMARDs or Disease-Modifying AntiRheumatoid Drugs are conventional oral therapy for Psoriatic Arthritis. These are first-line drugs for the disease.

Tumor Necrosis Factor(TNF) inhibitors are one of the most important medicines among DMARDs. According to the results published in the American College of Rheumatology, among the patients receiving TNF-alpha inhibitors, there is no increased risk of cancer. However, they indicate those patients have more possibility of having a malignancy. Given that PsA itself, skin psoriasis, phototherapy, and immune-modulatory treatment lead to cancer. By all means, they could identify many new patients with non-melanoma skin cancer (NMSC). Moreover, many people use systemic immunomodulatory drugs for a long time, such as methotrexate and cyclosporine. It also may be a reason for the increasing risk of cancer. Despite the above research on DMARDs, some studies evaluate there is a high risk of cancer in patients receiving conventional DMARDs. That’s why we have to accept that this is still not a stable theory.

The majority of the studies indicate the biological therapies (biological DMARDs) for psoriatic arthritis types don’t have any effect on developing the risk of cancer. Conversely, we need more data for exactly accepting this. Data from researchers currently show that there is an overall risk of cancer. Because all of these are inflammation-targeted therapies. However, non-TNF inhibitors and JAK- inhibitors are not yet completely evaluated.

 

What types of cancers related to psoriatic arthritis types?

Important to realize, that psoriatic arthritis types have close relation with,

  • Leukemia
  • Lymphoma
  • Breast cancer

These results are in Clinical Rheumatology based on a study in 2016.

In the same manner, results from a meta-analysis published in 2018, non-melanoma skin cancer have the highest risk value. Other than that, it indicates the following cancers related to psoriatic arthritis types.

  • Urinary tract cancer
  • Digestive tract cancer
  • Lymphoid/hematopoietic and related cancers
  • Respiratory tract cancer

Studies conducted and their outcomes

Hundreds of researchers are going on searching for the risk of cancer in PsA patients. They indicate both positive and negative results. Scientists use various study designs to find the actual link. For example, cohort studies, meta-analysis, and so on. Because they identified patients with psoriatic arthritis types, also positive for cancers.

  • A systematic review and meta-analysis on risk of cancer having PsA and psoriasis -The results (in 2020 published) indicated no risk of developing cancer with PsA.
  • In 2016, clinical rheumatology indicated breast cancer and skin melanomas present with PsA.
  • In 2014, Arthritis and Rheumatology published to say the rate of identifying new patients with cancer is similar for both psoriatic arthritis and rheumatoid arthritis.
  • The 2019 review indicates the relation of PsA to skin cancers. However, all DMARDs do not affect those cancers. These results are in ScienceDirect.

Overall, it is a challenge to evaluate the risk of cancer. In addition, most studies accept psoriatic arthritis has much less chance of developing cancer. This is true with the results compared with psoriasis. Psoriasis itself has a higher value towards the progression of cancers. This is not the only reason for cancer. You have to be aware of the other risk factors. Most of the time, these can be environmental threats. So, let us focus on what those things are.

 

The life expectancy of patients having PsA?

People with psoriatic arthritis have a 60% higher risk of having a shorter life expectancy than the healthy population. To clarify, PsA is a systemic disease. It attacks whole body systems. For example, systemic inflammation can harm the digestive system, skin, urinary system, and blood.

It is necessary to manage the disease well and prevent possible risk factors. By following these, you can live a life of yourself without any severe complications.

 

Risk factors for developing cancer with psoriatic arthritis?

  1. Smoking
  2. Excessive exposure to sunlight
  3. Unhealthy diets
  4. Excessive alcohol consumption
  5. Exposure of dust, and chemicals related to cancer
  6. Obesity
  7. Unhealthy lifestyle habits
  8. Physically inactive body
  9. Mental factors

Although some research indicates no risk of cancer with psoriatic arthritis, you can pay attention to those risk factors. It may be valuable.

How to prevent risk factors for cancer?

Most of the above risk factors are external threats such as environmental factors. So, it is not easy to avoid them every time. And still, you can make small changes and reduce those exposures.

Skin cancers            Avoid sitting in sunlight for a long timeStop smokingCover your skin as much as possible from excessive sunlightAvoid tanning bedsApply sunscreen with SPF protectionPay much attention to the changes in your skin regularly
Lung cancersStop smokingHave a healthy meal Avoid snacks and junk foodTry to avoid exposure to cancer-causing chemicals (asbestos, radon, arsenic, diesel exhaust, etc.)
Breast cancerMaintain a healthy lifestyleIdentify changes in your skinRegular checkups on your ownKeep in contact with your doctor get advice on the prevention of breast cancer.

Importance of knowing to prevent those risk factors?

Do you have psoriatic arthritis or even any other chronic disease, have you paid any attention to getting educated about the disease? It is a necessity to get good knowledge about your condition. Researches have shown patients having enough knowledge about their disease can have a higher rate of recovery. Patient education also includes the management of the disease.

As mentioned before, we cannot reverse exposure to certain risk factors. But, if you try to avoid them at least to a certain extent, it may be helpful. They are as follows,

  • You can have ideas on how to manage your disease well.
  • Your lifestyle may get normal even if you are with PsA.
  • Your mental status remains healthy
  • Relationships with your partners and other people become a success.
  • It reduces the side effects of medicines.
  • Future management of disease becomes easier.

Therefore, always keep in contact with your healthcare provider and have enough information. Make your mental health accept the disease and live with it.

Identify Psoriatic arthritis as one of the major types of arthritis in the hands

 

What are the characteristics of Psoriatic Arthritis types in hands?

Psoriatic Arthritis is one of the main types of arthritis in the hands. In any case, you may feel the following symptoms.

  • Stiffness
  • Swelling
  • Reduced movements
  • The pain of joints of fingers
  • Inflammation in hand and finger joints
  • Pitted nails
  • Nails get a different color and become thicker
  • Skin becomes scaly, bumpy
  • Silvery-white skin buildup and these are plaques
  • Fingers become an abnormal shape
  • Feel the tenderness of the fingers

You already know what the types of psoriatic arthritis in the hands are. When you have these types, usually psoriatic arthritis affects the joints close to your nails. Because of this, some might think this is gout. Your skin probably becomes scaly, red, and itchy. You may feel a burning sensation of psoriasis. Also, it might be painful. This can happen at the same time or in the same place, but not always.

How does Psoriatic Arthritis in hands affect your daily life?

Most of the patients feel uncomfortable with PsA. They think the disease blocks their daily routine. Besides, some may manage their pain and live their life happier instead. As a systemic disease, PsA affects lives. It affects the quality of lives mainly in two ways,

  1. Physically
  2. mentally.

 

Physical problems you may feel

In your everyday activities, you may feel difficulties. For example,

  •  Eating
  • Cooking
  • Washing
  • Gardening activities
  • Writing and drawing
  • Driving
  • Using hardware items
  • etc.

 

The mental impact of PsA in hands?

Other than physical impacts, a lot of mental effects may occur. Some patients feel sad, worried, and uncomfortable about themselves. But, many people somehow manage to do their daily activities instead.

Long-term illness can lead to anxiety and stress. The reasons are,

  • Low energy
  • Lack of sleep
  • Pain
  • Changes in food habits

Some try to avoid connecting with social groups and friends because they feel shame about themselves. Furthermore, it leads to depression when it becomes worse. In depression, people may feel,

  • Anger
  • Sadness
  • Guilty
  • No interest in enjoy life
  • Fatigue
  • Mood changes
  • Difficulty to get out of bed
  • Weight loss or gain
  • Headache
  • Stomachache
  • etc.

One of the best methods to overcome these problems is, talk to your doctor. Always keep the connection with your doctor or caregiver. Talk about your feelings with them. This will release your pressure outside and calm your mind and body.

  • Try meditation
  • Breathing exercises
  • Muscle relaxation exercises
  • Yoga.

These will help you relax your mind, control your heart rate, blood pressure, and muscle tension. Also, it helps to manage pain in arthritis.

How to overcome the pain of Psoriatic Arthritis in the hands?

Successful pain management is one of the best therapies. Especially, if you have other diseases with psoriatic arthritis, you need to reduce the pain you feel. You can follow simple home remedies.

  • Moisturize your skin often
  • Keep your fingernails trimmed and smooth
  • Apply ice cubes to the joints of your hands for 10 minutes
  • Avoid cut or pull cuticles.
  • Reduce the time you soak hands with water, prevent hands from drying
  • Avoid use fake nails
  • Always keep your hands clean
  • Practice hand exercises (get advice from your therapist)
  • Avoid carrying heavy piles or goods

In addition, take your medicines correctly. That is important. If you have fungal nail infections, meet your doctor and ask for treatment.

 

The effect of smartphone addiction on psoriatic arthritis types in hands?

In this case, Distal phalangeal (DIP) joints are the usual target for damage. Smartphones have become an essential electronic device. Most people, especially younger kids and adolescents, use this every day. Addiction to overuse of smartphones in PsA patients can worsen their condition.

Every time you use your smartphone, small joints of your hands activate. It means when you hold the device, click icons on the phone screen, and various other activities. For example, taking a picture, video your entire hand involves. There are fast movements of DIP joints and nails. According to a study in 2018 (results published in Journal of the European Academy of Dermatology and Venereology), smartphone overuse has an association with arthritis. They have used ultrasound scores to evaluate this. They found that smartphone overuse leads to higher signs of inflammation. The inflammation happens in muscles, bones, and hand joints. This is true for both psoriasis and healthy people. If you are healthy, overuse of smartphones can speed up the risk of arthritis in your hands.

 

What are the specific symptoms and treatments for Psoriatic Arthritis types?

 

What do you feel? PsA Symptoms

Symptoms are the changes you feel in your body or mind. They work as an early indicator of a disease. Psoriatic Arthritis can affect the whole body. So, you may feel various symptoms. Symptoms of psoriatic arthritis types are,

  • Fatigue
  • Stiffness around joints
  • Pain in joints
  • Difficulty moving joints
  • Fingers get sausage shape
  • Inflammation of finger and toes
  • Rash like red, pink, or brown patches on the skin
  • Scaly skin may get wrong as dandruff
  • Drop like skin lesions on upper body
  • Lakes of pus
  • Erythroderma

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Treatments for Psoriatic Arthritis Types

  • Current procedure

At the present moment, the acceptance is there is no cure for psoriatic arthritis. Therefore, doctors use several medications to reduce pain. Also, these treatments help to reduce the progress. It slows the disease to become severe.

  1. Disease-Modifying AntiRheumatoid Drugs (DMARDs) – slow the progression of the disease
  2. Methotrexate
  3. Sulfasalazine
  1. Non Steroidal Anti Inflammatory Drugs (NSAIDs)
  2. Ibuprofen
  3. Naproxen sodium
  1. Immunosuppressants – reduce the activity of your immune system
  2. Azathioprine
  3. Cyclosporine
  4. Leflunomide
  1. Biologics – a new class of DMARDs
  2. Adalimumab
  3. Infliximab
  4. Golimumab
  5. Secukinumab
  6. Ixekizumab
  7. Ustekinumab
  1. Newer oral drugs – controls the inflammation
  2. Apremilast
  1. Surgical procedures
  2. Joint replacement surgery – for severely damaged joints. Surgeons use artificial metal or plastic substances
  1. Steroid injection – reduce inflammation rapidly
  • Novel treatments for psoriatic arthritis types

Among the traditional treatments for psoriatic arthritis types, scientists continuously find new therapies. There are different aims of the treatments. For instance, to reduce disease progression, better pain management, improve the quality of life, etc.

Treat to target therapy is one of the novel treatments. Experts use Minimal Disease Activity(MDA) for this plan. What is treat to target therapy? Treat to target is a process. First physicians make a treatment goal for the patient. Second, they monitor the patient monthly. Third, if they cannot gain the desired outcome, they change the medicine plan for the patient. Finally, they regularly check the patient until the result appears.

This plan has shown valuable results. In addition to PsA, this is useful for rheumatoid arthritis.

Unfortunately, treat to target is not in daily clinical practice even now.

Nanoparticles usage has become increasing due to various advantages. There are several blockages of traditional therapies.

  • Difficult to monitor disease progression
  • Drugs lead to toxicities
  • Problems with drug delivery etc.

The unique nature of the nanoparticles makes them useful. We can use these as targeted delivery of drugs. The targeted delivery will reduce side effects. For example, leflunomide is an immunosuppressive agent. Leflunomide attacks several organs of the body when taken in usual routes. Delivering the drug to the target reduces side effects. In drug development, scientists use nanoparticles to create new dosage forms. Moreover, they have designed new diagnostic agents using nanoparticles. Overall, using nanomedicine is a novel discovery and evolution of treatments for psoriatic arthritis types. Those treatments will improve life also.

How can you use social media for your support? Do social media help the Psoriatic Arthritis Community?

Many social media platforms provide health information nowadays. Most people use social media like Facebook, Instagram, WhatsApp, Youtube, and even various websites. You can find several sites that provide free online help.

  • Free supporting apps
  • Whatsapp groups
  • Blog contents
  • Vlogs based on individual experiences etc.

For example, “PsA Healthline” is a free peer-support app for people having Psoriatic Arthritis. You can find similar apps and websites that provide medical information. These websites protect your confidential information. Besides, you have to be careful when sharing personal details. You can use those information and,

  • Get proper knowledge
  • Talk to people who have a similar experience – this will make you feel you’re not alone. You may feel more comfort and happiness with them. Sometimes you may not feel the same from a healthcare team.
  • Get health advice from healthcare workers
  • Home remedies to manage pain and side effects
  • Prevent future disabilities
  • etc.

At present, many people tend to search for information on their diseases. Education makes them more successful in disease management. Ultimately, it leads to a better lifestyle. That’s why you already read this article for the whole.

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