Selena Gomez has been candid about her battle with lupus since she was diagnosed with it in 2014. It’s no secret that the acclaimed singer and actress, 29, underwent chemotherapy to treat her autoimmune disease, and she’s opened out about how it’s affected her work and mental health, in addition to a kidney transplant in 2017.
The things that “should have knocked me down,” she stated in Elle magazine’s September cover story published Thursday, were her lupus, her kidney transplant, chemotherapy, having a mental illness, and going through very public heartbreaks.
Her remark about chemotherapy wasn’t the first time she’d heard of it: Back in 2015, Gomez revealed to Billboard that her therapies had pushed her out of the limelight and even fueled speculation about her substance abuse. “I was recently diagnosed with lupus and have since undergone chemotherapy as a result of that diagnosis. That was the genuine purpose of my vacation, “Gomez responded to the rumors in an interview with the magazine. “‘You folks don’t have any idea,’ I wanted to scream. Currently, I’m through chemotherapy. “You’re a bunch of jerks,” I said. Confidence and comfort were restored by locking myself in my room.”
As the name suggests, lupus is an autoimmune disease in which the body’s immune system assaults its organs and tissues. Lupus affects the skin, joints, heart and lungs, kidneys, and brain because it is a systemic disease. In the end, lupus treatment is based on the severity of a patient’s symptoms, although chemotherapy medications were used in Gomez‘s instance to reduce the immunological reaction that caused the disease.
Chemotherapy for lupus and other disorders (besides lupus and cancer) can be utilized by rheumatologists, so here’s what you need to know about how it works and alternative treatment choices for lupus.
How and why is Chemotherapy Used to Treat Lupus?
There are many other types of cancer treatments, but chemotherapy is the most widely used. Blood disorders and autoimmune diseases such as rheumatoid arthritis and lupus, as well as cancer, are among the conditions for which chemotherapy is prescribed by doctors.
Cancer and lupus may be treated with similar medications, but they are unrelated and should not be confused. Yale Medicine Rheumatologist and Yale School of Medicine Assistant Professor of Medicine Andrew Wang explain why cancer originates when cells reproduce improperly and become larger, causing damage to other cells and organs. In contrast, autoimmune disorders occur when the body’s cells fight themselves.
According to Dr. Wang, chemotherapy medications used to treat cancer can also help treat lupus because autoimmune is based on the same principles. The body’s cells must first divide before they can attack it. Dr. Wang tells Health that the idea is that if you can stop the rapid dividing phase, you can get rid of autoimmunity.
For patients suffering from autoimmune disorders, doctors administer chemotherapy medications in a manner that differs from that used for patients with other types of diseases. For lupus treatment, Amr Sawalha, MD, chief pediatric rheumatologist at the University of Pittsburgh School of Medicine, and director of the Comprehensive Lupus Center of Excellence, says that chemotherapy doses are far less compared to those for cancer treatment.
Doctor Sawalha tells Health he prefers to weaken the immune system rather than kill it. Lupus-targeted chemotherapy is known as an immunotherapeutic treatment, rather than merely chemotherapy, because of this.
Lupus patients have been prescribed a variety of chemotherapy medications, and the one the doctor chooses depends on the patient’s symptoms (and how severe they are). It is possible to consume some chemotherapy medications in pill form, while others are administered intravenously. Both cases, Dr. Sawalha explains, have considerably fewer negative effects than chemotherapy. A milder kind of hair thinning is possible with immunosuppressant medication. As for gastrointestinal difficulties like vomiting or diarrhea, Dr. Wang notes that they aren’t as common in most lupus patients as they might think.
According to Dr. Sawalha, even though chemotherapy treatments have fewer side effects, they are not without risk, and as a result, patients should be continuously monitored by their doctors during the treatment. It’s important to avoid depressing the immune system to the point that the patient’s white blood cell count drops, for example.
What are other treatment options for lupus?
Patients with lupus have a variety of treatment options, including chemotherapy. Lupus and autoimmune “share only a few medications with cancer,” according to Dr. Wang, who specializes in lupus research. Lupus patients are not prescribed many of the same medicines as cancer patients.
There are several ways to prevent autoimmunity, including using steroids, which inhibit the entire immune system. Doctors, on the other hand, employ steroids cautiously because of their negative effects—steroids impair the immune system and increase the risk of infection.
According to Dr. Sawalha, “our goal is to utilize steroids at the lowest dosage possible for the shortest duration to reduce the long-term negative effects. Doctors commonly employ steroids in conjunction with other therapies that take longer to take effect since they are faster acting than other drugs.
Instead of attacking the entire immune system, biologics, another therapy option for lupus, target specific cells involved in the creation of autoimmune antibodies. According to Dr. Sawalha, there are currently only two FDA-approved biologic drugs for the treatment of lupus: Benlysta (belimumab), which was first approved in 2011 for the treatment of SLE, and then active lupus nephritis (a kidney disease caused by lupus) in December 2020; and Saphnelo (nivolumab-final) in August 2021.
Dr. Sawalha adds he may administer hydroxychloroquine, an immunomodulator, combined with steroids for patients experiencing milder symptoms. Immunosuppressants would be considered for patients with more severe symptoms, such as kidney failure, as in the case of Gomez. We may increase the dosage if other treatments fail to control a patient’s condition, he says.
All of these treatments can benefit patients with lupus, but Dr. Sawalha notes that the optimal treatment options will depend on the patient’s exact situation and will be provided at the discretion of the patient’s complete medical team.