Skin Cancer Risk In Transplant Patients: Study Finds Odds Of Cancer Death Higher After Organ Transplant
People who received solid organ transplants (SOT) and survived after the operation have higher chances of dying early from cancer compared to the general population, as revealed by a new study in Canada.
Researchers in Toronto have found that those who undergo kidney transplant, liver transplant or other SOTs are up to three times more likely to die from cancer, with skin cancer among those posing the top risk for early death.
Despite the threats of cancer-related death, however, principal study author Dr. Nancy Baxter of St. Michael's Hospital, said dying from skin cancer is an uncommon cause of death, but it is an aggressive cancer.
Baxter, a colorectal surgeon, said both medical professionals and patients should be aware of this fact.
"It's really important for them to get that message because there are a number of things that transplant patients can do to reduce their risk of developing and having a serious problem related to skin cancer," she said.
How Patients Can Reduce Risks From Developing Skin Cancer
As skin cancer topped the list of cancers that cause early death in patients, Baxter said patients knowing about the risks will definitely be beneficial. She also said healthcare providers should focus on cancer screening and prevention.
Aside from getting regular skin checkups and avoiding extreme sun exposure, Baxter said patients should embrace widely accepted cancer prevention strategies. These include limiting the consumption of alcohol, avoiding smoking or quitting the habit, getting regular exercise, losing weight and eating a healthy diet.
Baxter and her colleagues also recommended SOT patients to use a personalized and tailored approach to cancer screening because some organized screening programs still have gaps. Some screening programs are not even effective at all.
Lung cancer screening with computed tomography (CT) scan may also overlook some lung transplant recipients, they said.
"We have to make sure we have a very tailored approach to these patients," said Baxter.
The Case Of A Former School Vice Principal
Janet Parr, a 54-year-old former school vice principal who had a heart transplant in 2013, said her doctors told her to be wary of getting too exposed to the sun's rays, and to regularly go through checkups to test for skin cancer.
"I now have a dermatologist, which I didn't have before, and I have to see that person once a year," Parr said, adding that before undergoing the organ transplant, she was well aware of the risks.
With that, she said she doesn't dwell on the fact that the transplant saved her life by preventing the cardiovascular disease, but that it increased her chances of getting cancer.
"For me personally it doesn't make one bit of difference. I think really what came from having the transplant is how fortunate I am that a donor was found and somebody agreed to be a donor or their family did," she said.
Drugs That Affect The Immune System Contribute To Cancer Risks
Dr. Quoc-Dien Trinh, co-author of the study's accompanying editorial, said there are several possible reasons why patients who undergo SOTs are at higher risks of dying from cancer.
First, Trinh explained that medications used to suppress the immune system during organ transplants to prevent organ rejection are likely to contribute to the elevated risks for cancer.
"[C]ancer arising in an immunosuppressed environment may be more biologically aggressive," he said.
Second, it may also be because cancer is more difficult to treat in transplant patients than in the general population, Trinh said. SOT patients may receive less aggressive cancer treatments due to fear that transplant rejection may occur, he said.
Key Findings Of The Study
To find the cancer incidence in SOT patients, researchers examined records from Canada's organ registry, which followed 11,000 patients who underwent SOTs in Ontario over a 20-year period.
Among the patients, about 3,068 have already passed away, and 603 or 20 percent of these deaths were cancer-related, the report said.
Excluding patients who have had malignancies before the operation, experts found that the risks of dying from cancer were still twice than that of the general population.
Children who received a transplant had higher risks for cancer-related deaths compared to organ recipients who were 60 years old and above.
Cancer is the second leading cause of death in SOT patients, with cardiovascular disease as the top leading cause, researchers said.
The study, which was conducted by experts in St. Michael's Hospital and the Institute for Clinical Evaluative Sciences, was featured in the journal JAMA Oncology.