Can Folic Acid Help Reduce Methotrexate Side Effects

What Is Metastatic Cancer?

Metastasis is the transfer of cells from one place to another. This process occurs when cancerous cells invade healthy tissue or other parts of the body. The most common type of metastases are those caused by certain types of blood cancers such as leukemia, lymphoma, myeloma and Hodgkin’s disease (all of which are called leukemias). Other types include brain tumors, bone tumors and liver cancers. Some types of cancer can spread through the air, such as lung cancer.

The risk of developing cancer increases with age. For example, men over 65 have a nearly 50% chance of getting prostate cancer compared to women under 45 years old.

A person’s lifetime risk for developing some types of cancer decreases with each decade after childhood. For example, the risk of dying from lung cancer drops by half between ages 40 and 59. However, there is no decrease in the risk for developing other types of cancer.

Cancer affects all races equally; however, African Americans have a higher rate than Caucasians of several types of cancer including melanoma (skin cancer), non-melanoma skin cancers (such as basal cell carcinomas) and head and neck squamous cell carcinomas.

While most types of cancer are not contagious, there are a few that can be spread from one person to another. These include genital warts and cervical cancer (related to the sexually-transmitted human papiloma virus).

Cervical cancer is the most common cancer in women throughout the world, with HPV being accountable for almost 5% of all cancers in women.

How Is Metastatic Cancer Treated?

The treatment for metastatic cancer depends upon the location of the tumor or tumors, the type of cancer, and how far it has spread. The main types of treatment are surgery, chemotherapy, immunotherapy and radiation therapy.

Surgery can be used to remove a tumor in case it is in a place where it can be easily reached and the doctor is able to completely remove all of it.

Chemotherapy uses anti-cancer drugs that can travel through the bloodstream to reach all parts of the body. Newer medications called monoclonal antibodies target only specific parts of the body.

This helps the drug more effectively attack the cancer cells while leaving healthy cells alone. The downside is that it is more likely to have side effects as well.

Immunotherapy stimulates your body’s immune system to attack and destroy cancer cells.

Radiation therapy uses high-energy rays or particles to damage and kill cancer cells.

Other Newer Treatments

Researchers are working on new targeted drug therapies to treat cancer. These drugs target specific types of mutations found in some cancers.

One such drug, vemurafenib (brand name Zelboraf), targets a specific mutation found in skin cancer known as melanoma. This treatment significantly extends the life span of patients with this type of skin cancer by about six months, especially when the cancer is in an early stage.

Clinical trials are ongoing to find new drug therapies and treatments for all types of cancer. These are done by pharmaceutical companies, the National Cancer Institute and other medical research organizations.

As of today, there is no known cure for metastatic cancer; however, many patients live a long time (especially those with the less aggressive types). Patients will continue to benefit from ongoing research to develop better drugs and treatment modalities that can help in the fight against cancer.

How Is Metastatic Cancer Detected?

Metastatic cancer is detected through physical examination, biopsies and imaging tests, such as CT or MRI scans. A colonoscopy, sigmoidoscopy or barium enema may be done to detect colon cancer metastases. A PAP smear is no longer used to detect cancer of the cervix that has spread to the uterus or surrounding tissue; instead, an MRI is used. A mammogram, ultrasound or biopsy may be used to detect cancer that has metastasized to the lymph nodes in the chest or tissue surrounding the tumor. A bone scan or x-ray of the skull may be used to detect osteoblastic metastases in bones such as the spine. PET (positron emission tomography) and CT scans are also used to image organs and locate cancerous tissues.

How Is Metastatic Cancer Prevented?

Cancer is a complex disease that develops due to a combination of factors, such as aging, bad diet, lack of exercise and genetic disposition. Metastatic cancer is a multifactorial disease caused by both genetic and environmental factors. Currently, there are no known ways to prevent metastatic cancer.

However, there are steps you can take to help prevent the most common types of cancer:

Avoid cigarette smoke and smog.

Maintain a healthy weight.

Quit smoking if you do smoke.

Eat a diet rich in fresh fruits and vegetables.

Exercise regularly.

Limit alcohol intake.

Get regular check-ups.

Remain stress-free.

Metastatic cancer is a major cause of death worldwide. It is important to catch this disease as soon as possible so treatment can be started.

The sooner a patient seeks medical help, the better the chance of survival.

Sources & references used in this article:

Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis by B Shea, MV Swinden, ET Ghogomu… – Cochrane Database …, 2013 – cochranelibrary.com

Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis by B Shea, MV Swinden, ET Ghogomu, Z Ortiz… – The Journal of …, 2014 – jrheum.org

Folate supplementation during methotrexate therapy for patients with psoriasis by BE Strober, K Menon – Journal of the American Academy of Dermatology, 2005 – Elsevier

The use of folic acid supplementation in psoriasis patients receiving methotrexate: a survey in the United Kingdom by B Kirby, CC Lyon, CEM Griffiths… – Clinical and …, 2000 – Wiley Online Library

Folic acid supplementation during treatment of psoriasis with methotrexate: a randomized, double‐blind, placebo‐controlled trial by A Salim, E Tan, A Ilchyshyn… – British Journal of …, 2006 – Wiley Online Library

Effect of folic or folinic acid supplementation on methotrexate‐associated safety and efficacy in inflammatory disease: a systematic review by S Prey, C Paul – British Journal of Dermatology, 2009 – Wiley Online Library

Methotrexate in rheumatoid arthritis: An updatewith focus on mechanisms involved in toxicity by AE van Ede, RFJM Laan, HJ Blom, RA De Abreu… – Seminars in arthritis and …, 1998 – Elsevier

Folate supplementation and methotrexate treatment in rheumatoid arthritis: a review by SL Whittle, RA Hughes – Rheumatology, 2004 – academic.oup.com

Do patients with rheumatoid arthritis established on methotrexate and folic acid 5 mg daily need to continue folic acid supplements long term? by SM Griffith, J Fisher, S Clarke, B Montgomery… – …, 2000 – academic.oup.com