Can Biologics for Psoriasis Be Used After Prostate Cancer Radiation Therapy?

Can biologic agents for psoriasis be used after radiation therapy for prostate cancer?

Hello, my father has been diagnosed with stage II prostate cancer and has undergone radiation therapy.
He has been monitored for two years, and his PSA levels are normal.
However, due to the impact of psoriasis, he is unable to take nutritional supplements to boost his immune system or traditional Chinese medicine for energy enhancement.
Is it possible to use biologic agents for the treatment or control of psoriasis on a self-pay basis? Thank you!

Luo Xiansheng, 40~49 year old female. Ask Date: 2022/11/25

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Currently, the use of biologics should be avoided in patients who have been diagnosed with cancer for less than ten years.
Different biologics may have varying effects on cancer treatment and recurrence, ranging from significant to minimal impact.
However, if a patient has had cancer for over ten years and there is no evidence of cancer recurrence, their condition can be considered stable or in remission, at which point the use of biologics may be considered, but this still requires evaluation by a physician.
There are many treatment options available for psoriasis, including various nutritional supplements, so it is advisable to discuss these with your doctor.
Treatment does not necessarily have to rely on biologics to be effective.
Given your father's current condition, it is still advisable to avoid biologics.
Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2022/11/25

More Info

When considering the use of biologics for psoriasis in a patient who has undergone radiation therapy for prostate cancer, there are several important factors to take into account. Your father's situation, having been diagnosed with stage II prostate cancer and having undergone radiation therapy, raises specific concerns regarding the safety and appropriateness of biologic treatments.

Biologics are a class of medications that target specific components of the immune system to treat conditions like psoriasis. While they can be very effective, their use in patients with a history of cancer, particularly those who have recently undergone treatment, requires careful consideration. The primary concern is that biologics can suppress the immune system, which may increase the risk of cancer recurrence or the development of new malignancies.

In general, it is recommended that patients who have been diagnosed with cancer avoid using biologics for at least ten years post-diagnosis, especially if they are still under surveillance for cancer recurrence. This is due to the potential immunosuppressive effects of these medications, which could interfere with the body's ability to monitor and respond to any cancerous changes. In your father's case, since he has been cancer-free for two years and has normal PSA levels, this is a positive sign; however, it does not completely eliminate the risks associated with biologic therapy.

It is crucial to have a thorough discussion with your father's oncologist or healthcare provider before considering the use of biologics. They can provide a comprehensive evaluation of his current health status, the stability of his cancer, and the potential risks versus benefits of starting a biologic treatment for psoriasis. There are alternative treatments for psoriasis that may be safer for someone with a history of cancer, including topical therapies, phototherapy, and systemic medications that do not carry the same level of risk as biologics.

Additionally, it is important to consider your father's overall health and any other underlying conditions he may have. Since he is unable to take immune-boosting supplements or traditional Chinese medicine for energy, this may further complicate his treatment options. The healthcare provider may suggest lifestyle modifications, dietary changes, or other supportive therapies that can help manage his psoriasis without compromising his health.

In summary, while biologics can be an effective treatment for psoriasis, their use in a patient with a history of prostate cancer, even if currently stable, should be approached with caution. A thorough evaluation by a healthcare professional is essential to determine the best course of action for managing psoriasis while ensuring the patient's safety and well-being. Always prioritize open communication with healthcare providers to explore all available options and make informed decisions regarding treatment.

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