Cancer Comorbidity in Patients with Multiple Sclerosis and Its Effect on Disease Course

Abstract

Abstract Aim; Multiple sclerosis is the most common inflammatory demyelinating disease of the central nervous system and it is important to do risk management well during the follow-up and treatment process. There are conflicting results in the literature regarding cancer development, which is one of the important comorbidities in multiple sclerosis. This study aimed to determine the frequency of cancer in our patients with multiple sclerosis and to evaluate the course of the disease in these patients. Method; Electronic patient records of 1280 patients with regular follow-up and up-to-date data from Ege University multiple sclerosis outpatient clinic were retrospectively reviewed. Data such as demographic information, comorbidities, family history, disability level, disease-modifying treatments , presence of cancer, type of cancer, multiple sclerosis, and cancer diagnosis dates were verified by interviewing the patients. Results; Seventeen patients with multiple sclerosis were found to have cancer, and the cancer frequency was calculated as 1.33%. Three of the seventeen patients had secondary progressive phenotype, while 14 had relapsing remitting multiple sclerosis. The most common cancer type in our patients with multiple sclerosis was breast cancer. There was no association between cancer development and any disease-modifying treatments. When we evaluated the course of MS in our patients who developed cancer, we see that all of them are inactive, and except for one patient who died due to breast cancer, the others are in remission in terms of cancer. Conclusion; Although cancer development is not common in patients with multiple sclerosis and its negative effect on the course of the disease has not been shown, cancer risk should be evaluated during follow-up and treatment and routine screenings should be performed for common cancers according to age and gender. Keywords: Multiple sclerosis, cancer, comorbities

Keywords

• multiple sclerosis
• cancer
• comorbidity

Multipl Skleroz Tanılı Hastalarda Kanser Birlikteliği ve Hastalık Seyirleri Üzerine Etkisi

Öz

Giriş ve Amaç: Multipl skleroz santral sinir sisteminin en yaygın inflamatuar demiyelinizan hastalığı olup takip ve tedavi sürecinde risk yönetimini iyi yapmak önemlidir. Multiple sklerozlu hastalarda en önemli komorbiditelerden biri olan kanser gelişim riski ile ilişkili literatürde çelişkili sonuçlar mevcuttur. Bu çalışmada kliniğimizde takip edilen multipl sklerozlularda kanser sıklığının belirlenmesi ve bu hastalarda hastalık seyrinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Ege Üniversitesi multipl skleroz polikliniğinden düzenli takipleri ve güncel verileri olan 1280 hastanın elektronik hasta kayıtları retrospektif incelendi. Hastaların demografik bilgileri, komorbiditeleri, aile öyküsü, engellilik düzeyi, kullandığı hastalık modifiye edici tedavileri, kanser varlığı, kanser tipi, multipl skleroz tanısı ile kronolojik sırası gibi veriler hastalar ile görüşülerek teyit edildi. Bulgular: On yedi hastada kanser varlığı saptanmış olup sıklık %1,33 olarak hesaplandı. On yedi hastanın üçü sekonder progresif fenotipte iken 14’ü relapsing remitting multipl sklerozdu. Multipl skleroz ve kanser birlikteliği olan hastalarımızdaki en sık görülen tip meme kanseriydi. Hastalık modifiye edici tedavilerin kanser gelişimi ile ilişkisine bakıldığında öne çıkan bir ajan saptanmadı. Kanser gelişen hastalarımızın MS seyrine baktığımızda hepsinin inaktif, meme kanseri nedeniyle exitus olan bir hastamız dışında diğerlerinin kanser açısından da remisyonda olduğu görülmüştür. Sonuç: Multipl skleroz hastalarında kanser gelişimi sık görülmemesine ve hastalık seyrini olumsuz etkisi gösterilmemiş olmasına karşın takip ve tedavide kanser riski değerlendirilmeli, yaş ve cinsiyete göre sık görülen kanserler açısından rutin taramalar atlanmamalıdır. Anahtar kelimeler: Multipl skleroz, kanser, komorbidite

Anahtar Kelimeler

• multipl skleroz
• komorbidite
• kanser

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