Aleksandra Lewandowicz-Uszyńska

Paraneoplastic syndromes and rheumatic diseases

Paraneoplastic syndromes, which are discussed in this paper, are a heterogeneous group of disorders associated with cancer, but not directly caused by the physical effects of the primary tumor or its metastases. May precede the appearance of the malignant process, occur simultaneously or disclose in the course of cancer. Paraneoplastic syndromes may be caused directly by toxins produced by tumor cells, occur in the course of hypersensitivity reactions, or be the result of release of intracellular antigens. Due to the often similar systemic symptoms it is very important to evaluate the association of rheumatic diseases and cancer. Most paraneoplastic rheumatologic syndroms are difficult distinguishable from idiopathic rheumatologic disorders. The most common paraneoplastic syndromes include rheumatoid arthritis (RA)-like syndrome arthritis, inflammatory myopathies, hypertrophic osteoarthropathy, vasculitis and Raynauds phenomenon.

Tumors in rheumatic diseases

Patients with systemic inflammatory rheumatic diseases (such as rheumatoid arthritis, lupus erythematosus, systemic sclerosis, idiopathic inflammatory myopathies, or Sjögrens syndrome) are at increased risk of cancer, including hematological malignancies (leukemias and lymphomas), as well as non-hematological cancers (e.g. lung, esophageal, prostate or ovarian cancer). This increased risk for cancer development in patients with rheumatic diseases is attributed to the immune (autoimmune) processes and the medical treatment. Due to the often similar symptoms and the occurrence of systemic paraneoplastic syndromes it is very important to evaluate the association between rheumatic diseases and cancer. This paper presents issues concerning the development of cancer in patients with rheumatic diseases and the risk of cancer associated with drugs used for the treatment of rheumatic diseases.