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Absolutely Petrified by Methotrexate
from Debbi C.

I was diagnosed late April 2005 with psoriasis.  Not much luck with penicillin, and four different kinds of creams and ointments.  At my last visit to my dermatologist (who is magnificent!) on August 12, 2005, he wanted me to start oral Chemo.  I was so stunned, shocked and hysterical, that I didn't retain much of what he said.  After seeing my reaction and taking into consideration that my skin thickness has not deteriorated and no arthritic symptoms have flared, he agreed to put on the strongest ointments for another 3 months. 

I have been trying to find info on the Web regarding the chemo but everything seems to be suited to doctors.  What bit I can understand has me absolutely petrified.  Liver biopsies, cirrhosis, renal failure, stomach miseries, Lymphoma, death, MS, and on and on.  Could you steer me to any sites that I can understand?  I'm not the swiftest on the computers, I kind of need my hand held.  From what I've seen I can't imagine going for it.  Thanks for any insight you can provide.

Sincerely, -Debbi C.


Ed’s Response: Methotrexate is the most-used “chemotherapy drug” for psoriasis and I'll assume this is what your dermatologist recommended.  Look it up by name at the National Psoriasis Foundation web site. 

The doses of methotrexate (also referred to as MTX) used to treat psoriasis are very small compared to the doses used as chemotherapy for cancer.  Considerable research was conducted after it was noted that cancer patients with psoriasis tended to clear while taking methotrexate.  That research yielded the safe dosages that are used today for treating psoriasis.

I have many correspondents who have used MTX for years with no adverse effects.  I've used the medicine myself for over three years (one year at a time, punctuated by a year on something else — so this has been over 5 years).  That said, MTX is toxic and patients who use it need to be monitored through blood tests at regular intervals.  U.S. derms still advocate liver biopsies once a cumulative dose of 1.5 grams has been consumed (for the average patient, that's about a year and a half on the drug).  In some European countries, new types of blood test are said to do away with the requirement for a liver biopsy and I'm hoping, one day, that will be the case here as well.

I hope this helps.  You really shouldn't fear using MTX ... but you should understand at the onset that you won't be able to use it forever and, when you stop, unless you find another treatment or therapy that works for you, your P will come back.  -Ed

Other links:
Dewke Methotrexate Journal

My Liver Biopsy

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