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Rheumatoid Arthritis and Lymphoma: What’s the Link?

By Susan Bernstein
WebMD Feature
Reviewed by David Zelman, MD

Sure, it’s scary to see an ad on TV that says your RA drugs might make you more likely to get lymphoma, a type of cancer in your lymph nodes. But that’s not something for most people to worry about, says Eric L. Matteson, MD, chair of rheumatology at the Mayo Clinic in Rochester, MN.

“The majority of this risk is related to RA, rather than the drug,” Matteson says. The disease increases the activity in your white blood cells and changes how they interact with bacteria or viruses, like the Epstein-Barr virus, in your blood. That’s what puts you at a slightly higher lymphoma risk.

Take Your Meds

Scientists have studied the links between RA drugs and lymphoma. They found that people with very active disease had a higher risk. Those whose RA was well controlled were less likely to get it.

Your drugs will help you stay healthy and active, Matteson says. “I tell patients that the benefits of their medications on disease control, quality of life, length of life, and long-term RA complications far outweigh these cancer risks.”

What’s the Link?

If you have RA, you’re twice as likely to get non-Hodgkin's lymphoma as someone without the disease. But even then, it’s “is still really rare,” says Vivian Bykerk, MD, a rheumatologist at the Hospital for Special Surgery in New York.

So what’s the connection for people with RA?

“The answer is simple. Inflammation,” says John J. Cush, MD, director of clinical rheumatology at the Baylor Research Institute in Dallas. “In some studies, we see that the worse the RA, the more inflammation and greater the risk of cancer.”

If your RA is severe and you’re not managing it well, or if you’ve had the disease for many years, you’re more likely to get lymphoma. But the chance of cancer goes up with age even in people who don’t have RA. 

What Are the Signs?

If you’re worried about lymphoma, have an honest conversation with your doctor, says Amanda Niskar, scientific director of the Arthritis Foundation.

Lymphoma is just one disease that can come along with RA. Don’t overlook other, more common health problems like heart disease, she says.

Some signs of lymphoma to watch for:

  • Unusual fatigue or bleeding
  • Fevers
  • Rashes
  • Unexpected weight loss
  • Swollen lymph glands

If you have these, or if a test leads your doctor to think you might have lymphoma, he’ll probably refer you to a specialist for more information and tests.  Make sure you get regular checkups as well as cancer screening tests like a colonoscopy or Pap smear, Cush says.

If you have a family member who had lymphoma, that doesn’t increase your risk of getting it and shouldn’t deter you from taking your RA drugs.

“These diseases are not that closely genetically linked,” Cush says.

Reviewed on December 18, 2015

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