People who have received organ transplants have a very high risk of skin cancer. Unfortunately, many of them don't realize it. Therefore, they don't take the necessary precautions to reduce their risk and to ensure that if they do get skin cancer, it will be detected and treated early.
People who have received organ transplants must take immunosuppressive medicines to keep their bodies from rejecting their new organs. People who take these medicines have an increased risk of skin cancer and tend to develop skin cancers that spread more quickly than those in other people.
It has been estimated that between 35 and 70 percent of organ transplant recipients will develop skin cancer within 20 years after their transplant surgery.
The most common type of skin cancer among people who have received organ transplants is squamous cell carcinoma. This type of skin cancer is a more serious problem in organ transplant recipients than in other people because it can spread to other parts of the body and grow quickly. It can even be fatal. Some organ transplant recipients develop more than 100 squamous cell carcinomas a year. These individuals have to visit a dermatologist for treatment of skin cancer very frequently.
Although immunosuppressive medicines play an important role in causing skin cancer in people who have received organ transplants, other risk factors are also important. Transplant recipients who are exposed to the sun have a higher risk than those who protect themselves carefully from sun exposure. Those with light skin have a higher risk than those with dark skin. However, even very dark skin does not provide complete protection against skin cancer in people who have received organ transplants. A study in Australia found that two of six heart transplant recipients who were Australian Aborigines developed skin cancer despite their very dark skin.
What Transplant Recipients Should Do
Transplant recipients need to be aware of their increased risk of skin cancer. They should be seeing a dermatologist regularly and should be taking careful precautions to protect themselves from the sun.
Patients who receive organ transplants are usually told about their increased skin cancer risk while they are in the hospital, but this type of education doesn't seem to work very well, perhaps because the patients have so many other things on their minds at that time. In one survey of about 300 patients who had received organ transplants, 62 percent said that they did not know they were at risk for skin cancer, only 21 percent had had an appointment with a dermatologist since the transplant, and only 28 percent said that they used sunscreen regularly. The researchers who conducted the study concluded that current methods of educating transplant recipients about skin cancer risk while they are in the hospital are inadequate, and that patients need additional follow-up education later on, after more urgent issues have been dealt with. Automatic referral of all organ transplant recipients to a dermatologist could also be helpful.
Although making regular visits to a dermatologist and protecting their skin from the sun are currently the most important steps that organ transplant recipients need to take to protect themselves from skin cancer, research is also coming up with new ideas. Clinical trials are underway to test medications that may help to prevent skin cancers in transplant recipients, and other types of preventive treatment are also being investigated. Preventive medications are already being used in some organ transplant recipients who tend to develop frequent and numerous skin cancers.