The sun and skin cancer in people with organ transplants
You have an increased risk of skin cancer if you’ve had an organ transplant. Research from abroad suggest that up to 40 % of all people, who receive organ transplants, will develop skin cancer over a 20-year period.
Source: cancer.dk and Urs Broby Johansen, specialist in skin disease
There are two common skin cancers: 1. Basal-cell carcinoma and 2. Squamous cell carcinoma. Basal-cell carcinoma almost never spreads. Squamous cell carcinoma can in rare cases spread to nearby lymph nodes. Malignant melanoma is also a skin cancer, but an entirely different and more dangerous disease than regular skin cancer
Increased risk shows itself in different ways
Skin cancer is typically more aggressive in people who have received transplants, it has a greater tendency to spread and cause relapse, compare to the rest of the population. Skin cancer is often seen 20-30 years earlier in organ-transplanted patients than in the population as a whole. The older you are at the time of the transplant, the sooner there’ll be an added risk of skin cancer after a transplant. Basal-cell carcinoma is the most common type of skin cancer in the general population. In organ-transplant patients, the most common type is squamous cell carcinoma.
- Squamous cell carcinoma appears between 65-250 times more often in organ-transplant patients compared to the general population.
- Basal-cell carcinoma appears 10 times more frequently in organ-transplant patients compared to the general population.
Immunosuppressant medicine increase the risk of skin cancer
Because of the immunosuppressant medicine, the immune system isn’t able to repair damage to the skin caused by sunlight and some viral infections, and this in turn means an increased risk of skin cancer. The risk of skin cancer is higher, the longer you’re being treated with immunosuppressant medicine.
Here’s how to reduce the risk of skin cancer
You can reduce the risk of skin cancer by avoiding direct sunlight, by self-examining your skin and by going to check-ups at a dermatologist.
Uv-rays from the sun and tanning salons are the most common cause of skin cancer, no matter if you’ve received a transplant or not. Prevention of skin cancer therefore revolves around minimizing these two sources. And it’s never too late to protect oneself against the harmful rays.
Here’s how to protect yourself from the sun
Avoid the midday sun between 12 and 15 (12 pm to 3 pm)
- Shade, clothes and a hat give the best protection. It’s best to use tight-woven clothes, long-sleeved shirts and trousers, sunglasses and a wide rimmed (> 10cm) hat. Buy UV-protected clothes/hats.
- Use sunscreen, when other forms of protection are unavailable – especially throat, neck, head and hands.
- Sunscreen should have both UVA- and UVB-blockers and preferably at least factor 30. You should use sunscreen because it’s likely that it’ll protect against basal-cell carcinoma and squamous cell carcinoma.
- Protect children against rays from the sun. Half of all the sunlight we receive throughout our lives is gotten during out childhoods.
- Avoid tanning beds – entirely.
- Examine your skin – early diagnosis is crucial. Maybe you can have someone help you, so you can have your back examined as well.
Almost all forms of skin cancer are curable if diagnosed early. Early signs of skin cancer are often new, red spots or changes to pre-existing spots, squamous areas that grow, blood spots on the skin, small cuts that won’t heal and irregular brown or black pigment spots.
The Danish Dermatologic Society’s recommendations
Danish Dermatologic Society (medical specialists in skin diseases) also recommend in their guidelines, that organ transplant patients go to regular check-ups.
So be sure to speak with your liver doctor or general practitioner about going to check-ups at a dermatologist. The frequency of check-ups is planned on an individual basis with your dermatologist/specialist.