It’s Time to Let Go of These RA Med Myths
Yes, there are risks with any drug you take. But let's sort fact from fiction about rheumatoid arthritis treatments.
I’ve always loved古代神话，尤其是有点可怕的那种。当你知道这个故事是虚构的，当它变得过于激烈时，你有能力放下这本书，你就能感受到肾上腺素的刺激。但是当神话直接影响你的生活时，它就没有那么有趣了。当你患有类风湿性关节炎（RA）并正在考虑服用药物时，你会发现许多神话、成见和误导，其中许多都很可怕，并伪装成事实。找到真相的金块可能需要很长时间，这将把你带到一个你可以根据事实而不是恐惧做出决定的地方。在这篇专栏文章中，我将为大家节省一些时间（和焦虑），并挑出关于RA药物的三个最顽固的神话，以及我发现的事实。
Myth #1: Biologics Cause Cancer
2005年，当我第一次服用TNF阻滞剂biologic时，我被告知潜在的严重副作用之一是增加患淋巴瘤的风险，淋巴瘤是一种癌症。无论如何，我决定服用这种药物，因为一场长达一年的严重类风湿性关节炎已经毁了我的生活。生命是我唯一的选择，而不仅仅是生活在痛苦的地狱里。现在，16年后，我们知道生物制剂实际上不会比RA更增加患淋巴瘤的风险。事实上，一项发表在Annals of Rheumatic Diseasesinvolving more than 15,000 RA patients who took a biologic found no increased risk for lymphoma. That said, biologics may slightly increase your risk of getting skin cancer.
The important thing to remember is that life comes with risk. Sometimes, people get skin cancer, die of heart attacks, are injured in car accidents, or fall in the shower. And yet, we continue skipping sunscreen, eating fast food for lunch, driving, and washing ourselves. We know that risk does not equal certain doom and find ways to manage that risk. You can deal with RA medication the same way. Educate yourself about what the risk actually means. For instance, when the studies show that biologics increase your risk of a skin cancer called squamous cell carcinoma by 30%, it sounds like a really high number. But according to the Arthritis Foundation, it actually means that one in 1,600 people treated by biologics will develop this type of cancer, a number which is a lot more emotionally manageable. Then approach it the way you do any other risk in your life and educate yourself about how to reduce it, for instance by talking to your doctor about theways to manage the risk of skin cancer.
Myth #2: All Medications Are Toxic
如果在关于风湿性关节炎药物的神话中使用的最可怕的词之一是“癌症”，那么紧随其后的一个词就是“有毒”我们被一种强烈的压力所包围，这种压力要求我们回归自然，避免使用化学物质，减少毒性，而且大多数情况下都是有充分理由的。确实存在影响我们和环境的有害物质，我们可能都同意应该减少这些物质。但药物本身有毒吗？一点也不。事实上，它们正在帮助我们所有人活得更长更健康。
I believe the idea of toxicity originates from two places. One, the fear of chemicals. And since包括人类在内的一切都是由化学物质构成的，这可能有助于明确说明这应该与DDT和石棉等“有害”物质有关。第二个因素可能是治疗RA的金标准甲氨蝶呤是一种化疗药物。然而，每周服用少量甲氨蝶呤以抑制RA，这与用于治疗癌症的大剂量甲氨蝶呤大不相同，后者旨在达到杀死癌细胞的毒性水平。你的医生可以帮助你理解其中的区别，以及某些化学物质对你恢复生活的帮助。这甚至可以帮助你忽略那些宣扬简单化神话的人。
神话#3：RA药物副作用会毁掉你的生活
Much like the previous myths, this one overdramatizes the reality. All drugs—not just those that treat RA—come with a risk of side effects. If you’ve ever done a Google search on a particular medication, you’ll find the long lists of warnings. For instance, have you ever looked at the laundry list of potential disasters on the side of your basic acetaminophen bottle? But that’s the key: Side effects are a possibility and far from inevitable. I am myself a bit of a side-effect magnet (thankfully mostly manageable), but there are lots of people who only have the good effects of RA meds. That might even be you.
Even if you do experience side effects, chances are they won’t stop you from getting on with your life. There is a reason that those lists of side effects are divided into common, less-common, and rare, with the scariest saved for that last category. If you get a side effect, it is most likely to be something fairly minor that you can manage. For instance, I experience extra gas, muscle aches, fatigue, and bit of queasiness for a few days after I take my medication, but compared to the way active RA ruined my life? It’s a no-brainer—I’ll take those side effects. But with a caveat: There are times when side effects affect your life as negatively as active RA. In those cases, your doctor can hopefully help you find another solution.
Myths are often based in a kernel of truth, but as we learned when playing the game of telephone as children, a story grows and changes the more it’s retold. So it is with the myths about RA medications—there simply isn’t one truth. As ever, real life is more complicated and when you factor in how wildly different we are from each other, there is only one that is right for you. Finding out what that is involves talking to your doctor and your family, reading reputable information, and some deep thinking about what you want in your life. And that’s all that matters.
RA药物与癌症：Arthritis Foundation. (2021.) “Rheumatoid Arthritis and Cancer Risk.”https://www.arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/arthritis-and-cancer-risk
RA药物和化疗：CreakyJoints. (2018.) “Is Methotrexate Considered Chemotherapy When Used to Treat Rheumatoid Arthritis?”https://creakyjoints.org/treatment/is-methotrexate-considered-chemotherapy-when-used-to-treat-ra/
