Being Well

Cancer in Transplant Patients: Know Your Risk Level and How to Lower It

Certain basic measures, like regular skin exams and other screening tests, help prevent cancer after an organ transplant.

In 2017 alone, almost 35,000 people received solid organ transplants in the United States, according to the U.S. Department of Health & Human Services. These remarkable procedures offer a second chance at life, helping people suffering from organ failure find new hope for the future. However, organ transplantation still has significant risks — including upping your risk for cancer.

Many people are unaware that the risk for cancer in transplant patients is higher. But research is underway to better understand the relationship between cancer and solid organ transplants. And while we don’t yet know all the reasons an organ transplant may increase your cancer risk, it’s hoped that further research will point to better screening and preventative factors to stop cancer before it starts.

Common Post-Transplant Cancers

An article in Clinical Kidney Journal explains that certain types of cancer are more common than others for people who have an organ transplant, including:

  • Skin cancers, such as squamous cell carcinoma and basal cell carcinoma
  • Kaposi sarcoma
  • Non-Hodgkin lymphoma
  • Lung cancer
  • Liver cancer
  • Kidney cancer
  • Colon cancer

Immunosuppression and Cancer in Transplant Patients

After their procedure, transplant recipients must take drugs that suppress the immune system (called immunosuppressants). These medications prevent the body from rejecting a new organ. But immunosuppressive drugs also prevent the body from fighting off infections as effectively as it normally would.

It’s thought that immunosuppression plays a key role in the development of cancer in transplant patients. When you take an immunosuppressive drug, your immune system is less able to identify and manage infections. According to an article in Cold Spring Harbor Perspectives in Medicine, this includes infections caused by certain viruses that have been linked to cancer, such as the Epstein-Barr virus, some strains of herpes, hepatitis B and C, and human papilloma virus (HPV). Additionally, your immune system is less able to recognize and neutralize precancerous or cancerous cells occurring within your body.

Certain immunosuppressive drugs, including azathioprine and cyclosporine, may actually exacerbate the damaging effects of ultraviolet (UV) radiation. UV radiation, which is present in sunlight, tanning lamps and tanning beds, prevents damaged DNA from repairing itself. Cells containing damaged DNA are more likely than normal cells to become cancerous, according to the American Society of Nephrology.

How to Help Stop Cancer Before It Starts

If you’re on the waiting list for an organ transplant and have concerns about your specific cancer risk, ask your healthcare team how you can help lower your likelihood of developing cancer. There are also several steps you can take to reduce your cancer risk as much as possible before and after your transplant procedure:

  • Avoid traditional risk factors for cancer, such as smoking and consuming excessive amounts of alcohol.
  • Following the Skin Cancer Foundation’s recommendations; protect yourself from UV radiation by limiting time spent in the sun and wearing sunscreen and protective clothing.
  • Pay attention to your body. If you develop worrisome symptoms, see your doctor immediately.
  • Schedule frequent health checkups with your doctor. After a transplant, you should have your skin checked at least once each year. Other important cancer screening tests, like Pap smears, mammograms and colonoscopies, should also be performed regularly.
  • Ask your doctor about your immunosuppressive medications. Lowering your dose or switching you to another drug may help reduce your cancer risk.

Having an organ transplant doesn’t mean you will get cancer, but being aware of the heightened risk helps you make health decisions that may mitigate it.

Learn your cancer risk factors and get tested regularly to keep yourself healthy. UVA Cancer Center offers cancer screenings for people from all backgrounds.

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Sarah Handzel, BSN, RN