
FRIDAY, June 20 (HealthDay News) -- Rheumatoid arthritis (RA) patients treated with methotrexate have an increased incidence of melanoma and other cancers, an Australian study says.
Methotrexate (MTX) is a disease-modifying anti-rheumatic drug (DMARD) commonly prescribed to RA patients. A link between the drug and cancer has been suggested, and there are even concerns that the drug itself may be carcinogenic, but research examining this concern has proven inconclusive.
This new study included 459 RA patients (309 women, 150 men) who started treatment with MTX prior to June 1986. During a total of 4,273 person-years of follow up (an average of 9.3 years per patient), 87 cancers were identified.
The researchers found that the RA patients who received MTX were 50 percent more likely than people in the general population to develop cancer of any kind. In terms of specific cancers, the RA patients had more than a fivefold increased risk of non-Hodgkin lymphoma, a threefold increased risk of melanoma, and almost a threefold increased risk of lung cancer.
The increased risk levels for non-Hodgkin lymphoma and lung cancer were similar to the findings of studies in Europe and in the United States. However, the increased risk for melanoma identified in this study was new.
"This study is, to our knowledge, the first to report an increased risk of melanoma in patients with RA treated with MTX compared with the general population," lead author Dr. Rachelle Buchbinder said in a prepared statement.
"Futher investigation is needed to determine whether this risk is unique to Australia and what role MTX, immunosuppression per se, and/or environmental factors such as exposure to UV radiation play in its development," she said. "Our findings, taken together with other studies investigating the risk of skin cancer in patients with RA, may support a role for regular skin cancer screening for all patients with RA, particularly those receiving immunosuppressive therapy."
The study was published in the June issue of the journal Arthritis Care & Research.
More information
The Arthritis Foundation has more about arthritis treatments
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SATURDAY, June 21 (HealthDay News) -- Summer is here, and many of you will be kicking off your shoes at home, at the beach or in the park. But is that a good thing?
To sort the myths from the facts about your feet, Dr. Tracey Vlahovic, associate professor of podiatric medicine and orthopedics at Temple University's School of Podiatric Medicine, offers this information about your tootsies with a caveat -- always check with your doctor before starting any treatment:
Myth: Flats, flip-flops and going barefoot are good for your feet.
Fact: "This is a common misconception, because we always hear about the problems with high heels," Vlahovic said in a prepared statement. "But these three present their own types of problems." Flip-flops provide no support, which can cause plantar fasciitis, ankle sprains and tendonitis. Wearing flats can lead to severe heel pain and blisters, crowding toes and conditions such as hammertoes and bunions. Walking barefoot leaves feet open to cuts, scrapes, bruises, and puncture wounds along with skin issues or nail injuries.
Diagnosis: Flip-flops or flats are fine for a few hours, but you should stretch your Achilles tendon for a bit if you wear them for longer than that, Vlahovic said. Save walking barefoot for around your own home, unless you are at risk for diabetes or have peripheral vascular disease. In those cases, always wear shoes in and out of the house.
Myth: Over-the-counter scrubs and soaks for corns are safe and effective.
Fact: "At-home soaks or scrubs would just exfoliate, not remove corns," Vlahovic said.
Diagnosis: A corn is a buildup of skin with a hard center. This often is caused by a hammertoe in which the toe knuckle rubs against the shoe. To permanently remove a corn, the hammertoe must be corrected so that it stops rubbing against the shoe. Or, just wear shoes with a wider toe box.
Myth: Feet don't need sunscreen.
Fact: "Skin cancer on the legs and feet actually has a high mortality rate due to people forgetting to do skin checks on that area. It's often caught too late," Vlahovic said. "This is due in large part to the fact that many people simply forget to apply or reapply sunscreen to the lower extremities."
Diagnosis: Apply sunscreen with an SPF of at least 15 and with both UVB and UVA protection every two to three hours to the feet. Apply more often if you're going to be at the beach, in and out of the water, or sweating.
Myth: All pedicure salons use sterile instruments, so it's fine to use theirs.
Fact: "Unfortunately, this is not the case with all nail salons," Vlahovic said. "As a result, the instruments can spread germs that can cause nail fungus and bacterial infections."
Diagnosis: Invest in your own nail files, clippers and cuticle sticks, unless you can be sure your nail salon sterilizes its instruments after each use. Also ask the technician if they have a clean bowl or basin or one with individual liners before sticking your feet in the motorized tub.
Myth: It's best to trim your toenails straight across.
Fact: Doing this, and cutting them too short, can lead to ingrown toenails, a true danger for diabetics. Untreated ingrown toenails can lead to infection and possibly an abscess requiring corrective surgery.
Diagnosis: Leave the nail slightly longer, trimming along the natural curve of your toe.
Myth: Soaking your feet in vinegar clears up toenail fungus.
Fact: "Vinegar can't penetrate the layers of the nail to get to the infection site. And without proper treatment, the infection can spread to other nails," Vlahovic said.
Diagnosis: See your dermatologist or podiatrist so they can perform a culture to see if it is definitely a fungal infection. Follow their instructions to the letter to avoid a recurrence.
Myth: Athlete's foot and warts aren't contagious.
Fact: Both are highly contagious, and easily spread in environments such as locker rooms or showers. They are often picked up through small breaks in the skin of the foot bottom.
Diagnosis: Keep your feet clean and dry, don't wear dirty socks and thoroughly clean your bath or shower area. "If one person in the household has it, everyone should be cautious and take proper precautions," Vlahovic said. If you must use a public shower, wear flip-flops.
Myth: Duct tape removes plantar warts.
Fact: Studies have shown duct tape to be one of the many ways to treat warts, but Vlahovic noted that several studies have shown duct tape in no better than a placebo.
Diagnosis: "If you have a plantar wart, don't pick or perform bathroom surgery on it," Vlahovic said "Don't put duct tape on it and expect it to go away, since there is a specific protocol for using it. See your dermatologist or podiatrist for this and other treatment options."
More information
The U.S. National Library of Medicine has more about foot health.