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More than 42,000 people received a solid organ transplant in 2022, according to the United Network for Organ Sharing. And while a new, healthy organ brings hope for improved health, transplant patients may be exposed to new health risks, due to immune-suppressing medications. These medications are necessary for helping their body accept the donated organ, but the drawback is that they suppress the body’s natural defenses against infection and cancer, such as skin cancer.
The risk of developing skin cancer is higher after an organ transplant.
Although immunosuppressants are essential for preventing graft rejection, they subdue the body’s ability to fight off certain diseases. As a result, the effects of this treatment can significantly elevate the risk of all types of skin cancer after transplant surgery. Compared to the general population, transplant patients are:
- 100 times more likely to develop squamous cell carcinoma
- Six times more likely to develop basal cell carcinoma
- Twice as likely to develop melanoma
- 24 times as likely to develop Merkel cell carcinoma
These cancers also tend to be more aggressive, growing more quickly throughout the body than in patients who have not undergone transplantation.
It’s important to know that other immune-related medications used to treat other medical conditions may also impact the immune system’s ability to fight against cancer. For example, patients undergoing chemotherapy for cancer treatment may have an elevated risk, as may patients taking medication for inflammatory arthritis. If you are considered “immunocompromised,” it’s important to discuss your risk of skin cancer with a doctor.
Other factors can impact your risk of cancer after transplantation.
If you’ve undergone transplantation, your skin cancer risk profile will vary based on several factors, including your skin tone, race, proximity to the equator, family history of cancer, and others.
Because most skin cancers are linked to excessive ultraviolet (UV) radiation exposure, your history of sun damage also plays a role. In addition, your risk level differs based on your medication type and dosage, as well as the length of time it’s taken.
Therefore, there’s no one-size-fits-all recommendation for screening frequency to detect signs of skin cancer early. Still, knowing your risk level can ensure you follow extra sun safety precautions. And, it’s important to follow-up with your doctor about how to perform regular self-exams. They’ll also help you evaluate and understand your risk level and provide recommendations for how frequently you should be screened by a dermatologist.
Sun protection remains the best way to reduce skin cancer risk.
While you may not be able to completely prevent skin cancer, there are many ways to minimize the risks of sun damage, whether or not you’ve undergone organ transplant surgery. Excessive sun exposure remains the highest risk factor for skin cancer, so it’s critical that people of all ages, races, and health conditions take precautions in the sun.
- Seek shade when the sun is the strongest. Peak sun hours are from 10 a.m. to 4 p.m., so it’s best to avoid direct sun exposure during this part of the day. Try to stay in the shade, especially if you’ve identified that you have a high risk of skin cancer.
- Wear sunscreen whenever you’re outdoors. Sunscreen is effective in blocking most of the sun’s harmful rays. Choose a sunscreen that is broad-spectrum, water-resistant, and has a Sun Protection Factor (SPF) of 30 or higher. Don’t forget to reapply every two hours.
- Stay covered. Wide-brimmed hats, sunglasses with UVA/B protection, and Ultraviolet Protection Factor (UPF)-rated clothing offer additional protection in the sun.
- Avoid tanning beds altogether. There’s no such thing as a healthy base tan, and tanning bed use is linked to a significantly higher risk of developing skin cancer.
While these sun safety guidelines are important for everyone, it’s especially important for those who are immunocompromised to be vigilant about protecting themselves.
Screening and early detection.
Whether or not you’re taking an immunosuppressant, knowing your skin cancer risk is critical to determining how frequently you should get screened. Regular self-exams and consistent follow-up with a dermatologist can increase your chances of finding signs of cancer earlier when it may be more easily treated.
Experts recommend monthly self-exams, which help you establish a baseline for what’s normal for your skin. Be sure to use a mirror or ask a partner to examine hard-to-see parts of the body, such as your back or scalp. Look out for any changes to the color, size, symmetry, or border of skin marks. If you’re concerned about something, it’s always good to talk to your doctor, even if it doesn’t end up being serious.
Even if you don’t see anything suspicious, ask a board-certified dermatologist how frequently you should come in for a skin cancer screening. Based on your medical history, past sun exposure, and other individualized factors, your doctor can help you stay proactive in managing your risk of skin cancer, giving you the best chance of a long and healthy life.
