Skin Cancer Risk High in Transplant Patients
NEW YORK, Mar 25 (Reuters Health) -- People who have undergone organ transplant -- particularly a heart transplant -- are at high risk of developing all types of skin cancer and should take extra care to protect their skin, according to a Minnesota expert.
One type of skin cancer, squamous cell carcinoma, is 65 times
more common in transplant patients who are taking
immunosuppressive drugs compared with the general population,
reported Dr. Clark Otley, professor of dermatology at the Mayo
Clinic in Rochester, Minnesota, at the 57th annual meeting of the
American Academy of Dermatology.
What's more, squamous cell cancers -- which rarely become life
threatening in the general population -- are also much more likely to metastasize and spread in organ transplant recipients.
Although squamous cell cancer is the most frequent skin cancer in
transplant patients, there is a 10-fold increase in basal cell
carcinoma and a 3.4-fold increase in melanoma, a more rare but
potentially life-threatening cancer.
It usually takes 20 to 30 years for a person whose immune
system is not suppressed to develop skin cancer. In organ
transplant patients, however, "this can happen in as little as 3
years" following transplantation, Otley said. Transplant recipients must take immune system-suppressing drugs for life to prevent rejection of the donor organ.
In the non-immunosuppressed person, the immune system
recognizes and destroys many small cancers as they develop so
that they never progress to clinically detectable skin cancer.
Patients who are immunosuppressed are less able to destroy
early cancers.
"Skin cancers thus progress to the point where they can ruin the
patient's life and sometimes, take their life as well," Otley
explained.
Organ transplant patients need regularly scheduled, full-skin
examinations by a dermatologist to detect and treat skin cancers.
"We also strongly encourage patients to receive (sun-protective)
education before and after they undergo transplantation and to
always use a sunscreen, wear protective clothing and avoid the
sun," Otley continued.
While all organ transplant recipients are at increased risk for skin cancer, more potent immunosuppression is often required
following heart transplantation than for other donor organs, and
so the risk of skin cancer is even greater in patients who have
received a donor heart.
Younger patients -- who increasingly are undergoing
transplantation -- are "of grave concern" as well, Otley noted.
They are extremely likely to develop skin cancer, including
melanoma, over their lifetime.
Copyright © 1998 Reuters Ltd. All rights reserved. Republication
or redistribution of Reuters content is expressly prohibited
without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon
permission for this reprint granted March 29, 1999