Renowned singer and actress Selena Gomez has long been candid about her battle with lupus since her 2014 diagnosis, but she recently revealed her brush with chemotherapy – here’s why the Disney star used the known cancer treatment for her autoimmune disease, plus what she wants others to know about the condition. 

In an interview with Health, Gomez shared that alongside her kidney transplant in 2017, she also underwent chemotherapy as part of her treatment for the autoimmune disease, stating that her health struggles also impacted her career, leading to periods of absence from the spotlight and a domino effect on other aspects of her health.

Reflecting on her journey, the 31-year-old told Elle magazine, "My lupus, my kidney transplant, chemotherapy, having a mental illness, going through very public heartbreaks—these were all things that honestly should have taken me down.”

Gomez with her kidney transplant donor Francia Raisa

Why is Chemotherapy Used to Treat Autoimmunity? 

Lupus is a chronic autoimmune disease characterised by the immune system's misguided attacks on the body's own tissues and organs. This systemic condition can affect various parts of the body, including the skin, joints, heart, lungs, kidneys, and brain. But you might be wondering why Gomez underwent chemotherapy without a cancer diagnosis – but it’s actually a common treatment for people with severe autoimmune diseases. Here’s why. 

Chemotherapy, commonly associated with cancer treatment, is sometimes used for lupus, a chronic autoimmune disease. While the idea of using chemotherapy for a non-cancerous condition may seem surprising, it's rooted in the shared underlying mechanism between cancer and autoimmune diseases like lupus.

In lupus, the immune system becomes dysregulated, leading to the production of autoantibodies that attack the body's own tissues and organs. This immune dysfunction can result in inflammation, tissue damage, and a range of symptoms affecting various parts of the body. Chemotherapy works by targeting rapidly dividing cells, a hallmark feature of both cancer cells and certain immune cells involved in autoimmune responses. By inhibiting the proliferation of these immune cells, chemotherapy can help dampen the overactive immune response characteristic of lupus.

Furthermore, chemotherapy drugs have immunosuppressive properties, meaning they can suppress the activity of the immune system more broadly. In the context of lupus, this immunosuppressive effect can help mitigate the inflammatory cascade and reduce the severity of symptoms associated with the disease. 

It's important to emphasise that the use of chemotherapy for lupus is typically reserved for cases where other treatment options have been ineffective or in situations where the disease is particularly severe and unresponsive to conventional therapies. Additionally, the dosage and duration of chemotherapy for lupus are often much lower and more targeted compared to cancer treatment regimens.

Ultimately, the decision to use chemotherapy for lupus is made on a case-by-case basis by healthcare providers, taking into account the individual's specific symptoms, disease severity, and overall health status. While chemotherapy may offer benefits in certain cases of lupus, it's essential to weigh the potential risks and side effects associated with this treatment approach and to explore alternative options when appropriate. 

Andrew Wang, Yale Medicine rheumatologist told Health that autoimmunity and cancer involve a similar process despite being worlds apart in nature. As we know, autoimmunity refers to the body’s cells attacking themselves, but like cancer, they must first divide before they can cause further damage.

"The thought is, if you can stop the rapidly dividing phase, you can get rid of the autoimmunity," Dr Wang told Health. 

Other Treatments for Lupus

• Antimalarials: Medications originally developed to treat malaria, such as hydroxychloroquine (Plaquenil) and chloroquine, are often prescribed for lupus. These drugs can help reduce lupus-related symptoms, including fatigue, joint pain, and skin rashes. Additionally, antimalarials are effective for preventing lupus flares and may have disease-modifying effects over the long term.
• Biologics: Biologic medications target specific components of the immune system involved in the pathogenesis of lupus. For example, belimumab (Benlysta) is a monoclonal antibody that inhibits the activity of B cells, which play a key role in the production of autoantibodies in lupus. Another biologic, anifrolumab-fnia (Saphnelo), targets type I interferon receptors to reduce inflammation and disease activity in lupus.
• Immunosuppressants: Immunosuppressive drugs, such as azathioprine (Imuran), methotrexate, mycophenolate mofetil (CellCept), and cyclophosphamide, may be prescribed for individuals with more severe or refractory lupus. These medications work by suppressing the activity of the immune system to prevent it from attacking the body's own tissues and organs. Immunosuppressants are typically used in combination with other lupus treatments and require close monitoring due to their potential side effects.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), can help alleviate pain, inflammation, and fever associated with lupus. These medications are often used to manage musculoskeletal symptoms and mild flares of the disease.
• Steroids (Corticosteroids): Corticosteroids, such as prednisone and prednisolone, are potent anti-inflammatory drugs that are used to suppress immune activity and reduce inflammation in lupus. Steroids can provide rapid relief of lupus symptoms during flares but are typically used at the lowest effective dose and for the shortest duration possible due to their potential for long-term side effects.
• Disease-modifying antirheumatic drugs (DMARDs): DMARDs, such as leflunomide (Arava) and sulfasalazine, are used to manage joint inflammation and other musculoskeletal symptoms in lupus. These medications work by modifying the underlying disease process and preventing joint damage.
• Topical Treatments: Topical corticosteroids, calcineurin inhibitors (e.g., tacrolimus), and other topical medications may be prescribed to alleviate skin manifestations of lupus, such as rashes and lesions. 

As for Gomez, she’s looking forward to acting, after acknowledging the career setbacks that have come with lupus – something many an autoimmunity sufferer will relate to.

Gomez Returns to Screens in Only Murders in the Building

In a candid interview with Billboard in 2015, she revealed, "I was diagnosed with lupus. That's what my break was really about."   

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