Arthritis Patients Often Believe They Are Being Given Chemotherapy and A Rheumatologist is On A Mission To Change That

Methotrexate is the foundation medication in rheumatology worldwide and is also used at far higher doses in cancer treatment.

YORBA LINDA, CA, UNITED STATES, October 9, 2026 /EINPresswire.com/ — A patient with rheumatoid arthritis receives a prescription, goes home, searches the medication and finds it described as a cancer drug.

Dr. Nisha Manek, a rheumatologist who spent 12 years at Mayo Clinic in Rochester, Minnesota, said the fear that follows is among the most common she encounters and among the most avoidable.

“Methotrexate is the foundation of what we do,” Manek said. “You can go to Stanford, to Harvard, anywhere in the world, and they will give you methotrexate. It is also used intravenously at very high doses to kill cancer cells. Those two facts sit next to each other, and almost nobody explains the difference.”

The doses are not comparable, she said.

“In rheumatology, the amounts are minuscule by comparison,” Manek said. “It is regulating an immune response rather than attacking anything.”

She said the reaction is consistent.

“You can see it in their eyes before they say anything,” Manek said. “The word cancer is sitting in the room. And when you explain it properly, people tell you nobody has ever said that to them. That happens constantly.”

Manek said the issue is not the medication but the time available to discuss it.

“Someone gets 10 minutes, a prescription and a follow-up appointment,” she said. “There is not room in 10 minutes to unpick what somebody read at 2 AM in the morning.”

She said the most frequent thing patients raise with her has nothing to do with medication.

“They tell me they feel invisible,” Manek said. “That nobody has examined them in years. That the people treating them do not know their name. That is what they carry in, before we discuss anything clinical.”

She added that patients often arrive expecting rheumatology to manage pain, and that the distinction is worth understanding.

“We are not a pain management specialty; we are immune system management,” Manek said. “Once you address the inflammation, the pain responds. That has generally not been explained either.”

Manek left Mayo Clinic in 2012 to study energy medicine and consciousness research from a physics perspective. She is the author of “Bridging Science and Spirit” and works with a small number of clients navigating chronic inflammatory conditions.

*Manek NJ, Hart D, Spector TD, MacGregor AJ. The association of body mass index and osteoarthritis of the knee joint: an examination of genetic and environmental influences. Arthritis Rheum. 2003 Apr;48(4):1024-9. doi: 10.1002/art.10884. PMID: 12687544.

For more information contact: www.nishamanekmd.com

Nisha Manek, MD
Nisha Manek, MD
+1 507-269-5252
nisha@nishamanekmd.com
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