Ankylosing Spondylitis and Cancer: What’s the Relationship?

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Ankylosing spondylitis is associated with an increased risk of cancer.

This article discusses the connection between ankylosing spondylitis and cancer and how healthcare providers approach treatment when someone develops both.

Doctor talking to older woman patient

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Connection Between Ankylosing Spondylitis and Cancer

Ankylosing spondylitis develops when the joints in the spine become chronically inflamed. While many things can cause cancer, the chronic inflammation present in ankylosing spondylitis damages DNA, and over time, those changes can lead to cancer.

People with ankylosing spondylitis develop cancer at a rate of 256.3 people per 100,000 people. This increased risk isn’t associated with one cancer but many, such as:

  • Upper respiratory cancer
  • Digestive cancers
  • Colon and rectum cancers
  • Lung cancer
  • Bone cancer
  • Connective tissue cancers
  • Melanoma and nonmelanoma skin cancers
  • Breast cancer
  • Testicular cancer
  • Prostate cancer
  • Urinary bladder cancer
  • Kidney cancer
  • Brain cancer
  • Thyroid cancer
  • Endocrine cancers
  • Blood cancer

What Is the Most Common Cancer in People With Ankylosing Spondylitis?

No one type of cancer is found in people with ankylosing spondylitis, but some are more common than others. People with the condition are most likely to develop the following:

  • Cancers that affect the digestive tract and organs such as the colon, liver, and stomach
  • Blood cancers such as multiple myeloma and lymphoma
  • Prostate cancer 


The risk associated with cancer and ankylosing spondylitis has to do with inflammation and gene variations. There are several genes associated with the development of ankylosing spondylitis, including:

  • HLA-B 
  • ERAP1
  • IL1A
  • IL23R

These genes play a role in immunity and how well the body fights off infection and disease. In people with ankylosing spondylitis, variations or changes to these genes trigger inflammation that causes the disease to develop. These same genes, namely HLA-B and ERAP1, also play their own role in developing many specific types of cancer, such as Hodgkin lymphoma.

People with ankylosing spondylitis are significantly less likely to beat cancer and more likely to develop cancer earlier in their lives than the general population. Certain medications, mainly biologics, may also increase the risk of cancer. Because they are often used as a treatment for ankylosing spondylitis, it adds to the risk of cancer.

Cancer Survival and Ankylosing Spondylitis

Beating cancer relies heavily on factors such as a person’s current health, lifestyle, and stage when it is found. Ankylosing spondylitis increases the mortality rate of cancer.

Treatment and Management of Ankylosing Spondylitis With Cancer

When a person develops cancer when they already have ankylosing spondylitis, cancer treatments are the same as they would be without AS. Possible therapies are:

  • Surgery to remove tumors
  • Radiotherapy
  • Chemotherapy
  • Drug therapy

Many treatments for ankylosing spondylitis involve using immunosuppressants, which are medications designed to hinder the action of the immune system. These medications are used in ankylosing spondylitis to try to curb inflammation.

If a person with ankylosing spondylitis has to undergo chemotherapy, it is recommended that all immunosuppressant medications be stopped until after remission. Drugs that decrease the action of the immune system can make chemotherapy less effective.

As with all types of cancer treatment, people should manage their health during their therapy by:

  • Eating a healthy and well-balanced meal
  • Avoiding smoking, alcohol and other vices that could contribute to a worsened outcome
  • Managing stress effectively
  • Getting enough sleep
  • Joining a support group for people with cancer for emotional support 

The best thing a person with ankylosing spondylitis can do is monitor any changes in their health and get regular cancer screenings in the first three years following their diagnosis. That way, if cancer does develop, they will likely catch it as early as possible.

Managing Side Effects With Ankylosing Spondylitis

Cancer treatment has various side effects, such as nausea and vomiting, pain, hair loss, brain fog, and depression. When a person is dealing with both cancer and ankylosing spondylitis, coping with these side effects can be that much more difficult. It’s important to discuss what to expect and how to manage both diseases effectively with your healthcare team.


It is difficult to reduce the risk of developing cancer if you have ankylosing spondylitis. However, you can reduce your overall risk by engaging in healthy lifestyle practices like stress management, quitting smoking, maintaining a healthy weight, and protecting your skin from harmful ultraviolet (UV) rays.

You can also increase your risk of finding any cancer that does develop early by participating in regular cancer screenings after being diagnosed with ankylosing spondylitis. 

Watching for Cancer Symptoms

If you have recently been diagnosed with ankylosing spondylitis, you should pay attention to your body and how you feel. That way, you will be able to notice any changes, no matter how subtle they are, that could point to cancer. Some early signs of cancer include:

  • Unexplained weight loss
  • Fatigue
  • Fever
  • Pain
  • Skin changes


Changes in DNA and cell damage caused by ankylosing spondylitis can develop into several types of cancers, some of which are more common than others. Treating cancer often takes priority when a person develops cancer after being diagnosed with ankylosing spondylitis.

Any medications that can counteract cancer therapy, such as immunosuppressants, are typically stopped during cancer treatment. To ensure overall health while coping with the diseases, a person with both should be aware of factors that they can control.

A Word From Verywell

Knowing the risk of cancer after an ankylosing spondylitis diagnosis may seem like more bad news. However, it puts you in a good position to screen and monitor yourself for symptoms or signs of cancer before it spreads and becomes more dangerous. Fortunately, cancer treatments are becoming more and more effective.

Frequently Asked Questions

  • What causes cancer in people with ankylosing spondylitis?

    Inflammation and gene changes that occur in ankylosing spondylitis play a role in cancer development. That is because chronic inflammation damages DNA, priming the area for cancer cells to grow out of control. Medications to treat ankylosing spondylitis can also increase a person’s risk of developing cancer.

  • How do you treat cancer in people with ankylosing spondylitis?

    Cancer treatments are the same in those with and without the disease. They can include chemotherapy, radiation, and surgery to remove tumors. In people with ankylosing spondylitis, the type of therapy will depend on what kind of cancer they have, what stage it is in, and what medications they have been on for their condition.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Angelica Bottaro
Angelica Bottaro is a professional freelance writer with over 5 years of experience. She has been educated in both psychology and journalism, and her dual education has given her the research and writing skills needed to deliver sound and engaging content in the health space.