A topic that has arisen lately in the Crohn’s and ulcerative colitis community is the risk of some types of cancers due to the medications that we take.

Most medications taken by those with inflammatory bowel disease (IBD) do not present an increased risk of cancer, but some exceptions may exist. Studies suggest that biologics and thiopurines may carry an increased risk of melanoma and nonmelanoma skin cancer and lymphoma.

Biologics and thiopurine medications

Many types of immunosuppressant medications, which are used to treat several autoimmune conditions, are available. In this column, I will discuss biologic and thiopurine medications.

High levels of a protein called tumor necrosis factor (TNF) are associated with inflammation in the digestive systems of those with Crohn’s disease. Biologic medications, or anti-tumor necrosis factor (anti-TNF) therapies, target those proteins and prevent them from attacking organs. Biologics are an effective treatment for moderate to severe Crohn’s disease to keep symptoms under control and maintain remission.

Thiopurines, such as azathioprine, target T-lymphocytes, or T-cells, which are another cause of inflammation in IBD. Both types of medications have shown positive results in treating IBD. When combined, they can be even more effective in controlling symptoms, maintaining remission, and improving overall quality of life.

Benefits vs. risks

Every medication carries a risk of side effects. A 2012 study published in the journal Gastroenterology found that in those with IBD, the use of biologics increased the risk of melanoma, and thiopurines increased the risk of nonmelanoma skin cancer.

In a separate study reported in JAMA in 2017, researchers found an increased risk of lymphoma in patients with IBD taking anti-TNF therapies or thiopurines. When biologics and thiopurines were combined, the risk of lymphoma was higher than either medication alone.

When looking at treatment options, your doctor will weigh the potential benefits against the possible risks. The American College of Gastroenterology strongly recommends that IBD patients get screened for melanoma and nonmelanoma skin cancer. Melanoma screening is advised for those with IBD independent of the use of biologics, while nonmelanoma screening is recommended for those taking thiopurines.

Join the discussion about IBD therapies in the comments below. 

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Note: IBD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of IBD News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to IBD.