Doctors typically only recommend chemotherapy for Crohn’s disease in very specific circumstances, including when other standard treatment methods fail.
There are also some safety factors to consider. It is also worth noting that only some chemotherapy drugs might work.
In this article, we will look at how well chemotherapy for Crohn’s disease works, available types, and whether there are any side effects.
Can chemotherapy help treat Crohn’s disease?
A doctor may recommend chemotherapy for Crohn’s if other treatments are unsuccessful.
There is currently no cure for Crohn’s disease. For this reason, treatment focuses on reducing symptoms so that the person can go about their daily life.
It is possible for the disease to go into remission, which is a period when the disease causes few to no symptoms.
Medical treatment aims to achieve this remission and, with the help of other medicines and lifestyle changes, keep the disease in remission for as long as possible.
Crohn’s disease is a category of inflammatory bowel disease (IBD), and most people with Crohn’s disease respond well to traditional IBD therapy methods. These include corticosteroids, immunosuppressants, and 5-aminosalicylic acid drugs.
A doctor may also choose to prescribe specific medications for individual symptoms, such as an antidiarrheal drug if the person is experiencing diarrhea.
However, in some cases, Crohn’s disease does not respond well to drugs, and symptoms may continue or get worse. When this occurs, a doctor may prescribe certain chemotherapy drugs to help treat it.
Is chemotherapy for Crohn’s safe?
In many cases, taking chemotherapy and biologic drugs help put troublesome symptoms of Crohn’s disease into remission. This is important, as these symptoms can disrupt and interfere with a person’s daily life.
It is also important to note that ongoing inflammation in the intestines can lead to separate problems over time.
Keep in mind, however, that many chemotherapy drugs do carry risks. For instance, many drugs work against the immune system. While this may help reduce Crohn’s symptoms, it might also increase the risk of other issues, such as infections taking hold in the body.
Anyone undergoing chemotherapy for Crohn’s disease will want to work closely with their doctor and monitor any new symptoms and adjust treatment as necessary.
If a person does not respond well to one medication, they may need to switch to a different drug.
Types of chemotherapy for Crohn’s
There is a range of chemotherapy drug that doctors can recommend for people with Crohn’s disease. Each may have a varying degree of success in different people, and there are risks and side effects associated with each.
A doctor can administer chemotherapy drugs intravenously or by injection.
Infliximab (Remicade) is a type of tumor necrosis factor (TNF)-blocker.
TNF is a specific protein that helps regulate the immune cells. Part of its job includes creating inflammation. In a disease such as Crohn’s, where such inflammation may run wild, doctors may recommend TNF blockers to help suppress inflammation.
Doctors may administer infliximab through an injection or intravenous line, and the treatment is typically ongoing. This means that the person has to visit their doctor or healthcare provider repeatedly to continue treatment.
Common side effects include a headache and nausea, as well as other immune system side effects, such as unexplained rashes.
Some people may have an allergic reaction to the drug. It is essential to report any symptoms to a doctor for evaluation. The doctor may want to change the dosage or have the person stop taking the drug altogether.
Doctors usually prescribe methotrexate (Otrexup) to treat cancer. However, it also has the potential to treat immune disorders, such as IBD and rheumatoid arthritis, albeit in a much lower dosage.
They will typically only prescribe methotrexate when other treatment options fail, as it has some strong effects in the body.
The drug lowers cell production to reduce the activity of the condition. A side effect of this is that the bone marrow may not make as many red blood cells. People taking methotrexate may require regular checkups, including blood tests, to check for other complications.
Other common side effects include fatigue, nausea, vomiting, and mouth ulcers. Methotrexate also blocks folate intake in the body, so is important that people take folate or folic acid supplements.
Adalimumab (Humira) is another TNF-blocker that may be helpful in treating Crohn’s disease. It is available as an injection. Adalimumab works by binding to the TNF-alpha cells, preventing them from causing inflammation.
Adalimumab may reduce the body’s ability to fight off infections. So, people taking the drug may be at increased risk of developing severe or even life-threatening infections.
Mercaptopurine (6-MP), marketed under the name Purinethol, is a chemotherapy drug that may help some people with Crohn’s disease. Doctors may recommend the medication when symptoms are in remission to help maintain that remission for as long as possible.
6-MP may also cause side effects, such as nausea, vomiting, hair loss, or an unexplained rash. Other more severe side effects are possible, however, and anyone taking the drug should report all side effects to their doctor.
Cyclophosphamide (Cytoxan) is another chemotherapy drug that may also be helpful in Crohn’s disease.
As a recent study in the journal Inflammatory Intestinal Diseases notes, cyclophosphamide pulse therapy (CPT) may help put Crohn’s symptoms into remission when other methods fail.
Side effects of CPT vary from person to person. The most common side effects are fatigue, nausea, and vomiting. Some people may also experience mild infections or sleep disturbances.
The link between Crohn’s and cancer
A person with Crohn’s disease may have an increased risk of developing cancer.
As one study in the journal Annals of Gastroenterology notes, those with IBD who undergo chemotherapy are not at a higher risk for cancer.
However, the condition itself may cause a slightly increased risk of certain cancers. The authors say that people with Crohn’s disease have an increased risk of small bowel adenocarcinoma.
However, other drugs that doctors recommend for IBD, such thiopurines, can also raise a person’s risk of cancer.
According to a study in World Journal of Gastrointestinal Pharmacology and Therapeutics, people who use thiopurines are four to five times more likely to develop lymphoma.
The use of chemotherapy medications does not seem to increase the overall cancer risk in people with IBD.
Crohn’s is a persistent disease with no known cure. Some forms of chemotherapy may help treat the symptoms and put the disease into remission. However, doctors may only prescribe chemotherapy treatments for people who do not respond well to conventional treatments.
As with any treatment, doctors will want to monitor a person closely to check for any unwanted side effects or complications.
For the most part, chemotherapy is a helpful way to treat particularly troublesome forms of Crohn’s disease.