This Was Selena Gomez's Lupus Treatment

Since her diagnosis in 2014, Selena Gomez has been open about her journey with lupus. In addition to a kidney transplant in 2017, the singer and actress shared she's undergone chemotherapy to treat her autoimmune disease. Gomez also said the treatment affected her career and mental health.

"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 told Elle magazine.

In 2015, Gomez shared with Billboard that her treatments forced her out of the spotlight and even sparked rumors of addiction. "I was diagnosed with lupus, and I've been through chemotherapy. That's what my break was really about," Gomez told the magazine. Here's what to know about how chemotherapy works for lupus and other treatment options.

What Is Lupus?

Systemic lupus erythematosus (SLE), also called lupus, is a chronic autoimmune disease that occurs when the immune system attacks tissues and organs. Because it's a systemic condition, lupus can affect many body parts, such as the skin, joints, heart and lungs, kidneys, and the brain.

Lupus treatment ultimately depends on a person's symptoms and their severity. However, in some cases—including Gomez's—healthcare providers use chemotherapy drugs to suppress the autoimmune response responsible for the disease.

Why Chemotherapy Is Used To Treat Lupus

Chemotherapy is a type of drug that kills the body's cells, and it's most commonly known as a drug to treat cancer. Healthcare providers also use chemotherapy for other diseases, including blood disorders and autoimmune diseases like rheumatoid arthritis and lupus.

Andrew Wang, MD, PhD, Yale Medicine rheumatologist and assistant professor of medicine at Yale School of Medicine, told Health that chemotherapy drugs used for cancer can help with lupus because autoimmunity involves a similar process to cancer development.

Autoimmune diseases happen when the body's cells attack its own tissues and organs. Before cells can attack the body, they first divide. "The thought is, if you can stop the rapidly dividing phase, you can get rid of the autoimmunity," said Dr. Wang.

How Is Chemotherapy Different for Lupus?

Amr Sawalha, MD, chief of the division of pediatric rheumatology and director of the Comprehensive Lupus Center of Excellence at the University of Pittsburgh School of Medicine, told Health that chemotherapy for lupus is typically a much lower dose than cancer treatment.

"Rather than killing the immune cells, we suppress them enough that they stop attacking organs and tissues of the body," explained Dr. Sawalha. For that reason, Dr. Sawalha said, providers usually call lupus-specific chemo treatment "immunotherapy treatment" rather than "chemotherapy."

Other Treatment Options

Chemotherapy is just one treatment option for those with lupus. A healthcare provider may prescribe one of the following treatments:

• Antimalarials are beneficial for flare-up prevention and symptoms like fatigue, inflammation, joint pain, and skin rashes.
• Biologics target specific cells involved in creating autoimmune antibodies rather than the entire immune system. Two FDA-approved biologics for lupus treatment are Benlysta (belimumab) and Saphnelo (anifrolumab-fnia).
  
• Immunosuppressants are immune system-suppressing medications typically used in severe cases of lupus. If steroids don't work, or the dosage needs to be reduced, a provider may prescribe immunosuppressants.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) may be helpful for people who experience pain and fever.
• Steroids help suppress the entire immune system to prevent autoimmunity by reducing inflammation.

Overall, the best treatment methods will depend on the individual's specific situation and be prescribed at the discretion of the patient's entire medical team.

Side Effects of Chemotherapy and Other Medications

Dr. Sawalha said the side effects are usually far milder when using chemotherapy for lupus than with cancer treatment. For example, immunosuppressants can cause hair thinning like chemotherapy, but it's not as severe. While some individuals with lupus experience gastrointestinal problems like vomiting or diarrhea, said Dr. Wang, those issues aren't nearly as bad in most people with lupus.

Other medications used to treat lupus can result in side effects as well. The following chart outlines some possible side effects a person might experience.

What Happens After a Kidney Transplant?

If you receive a kidney transplant, you may experience immediate relief. Sometimes, a new kidney may not work until a few days later.

Taking anti-rejection medications, or immunosuppressants, ensures your body accepts and does not attack the new kidney. Other medications may be necessary post-procedure, depending on what your treatment team recommends or prescribes.

A Quick Review

Along with having a kidney transplant, Selena Gomez used chemotherapy to help treat her case of lupus. Chemotherapy is helpful for lupus because it can reduce the immune system's response of attacking healthy cells in the body.

There are other treatments for lupus, like antimalarials, steroids, and NSAIDs. However, lupus treatments—including chemotherapy—come with various side effects, from GI problems to increased infection risk.