At-risk skin cancer patients
Increased risk with immunosuppressive therapy
People who have received an organ transplant have a significantly increased risk of developing skin cancer.
This is due to the medications required for life to prevent the body from rejecting the transplanted organ. These medications suppress the immune system, reducing its ability to detect and repair damage to skin cells. Over time, such damage may develop into skin cancer.
The risk increases with the duration of immunosuppressive treatment and is particularly elevated for squamous cell carcinoma.
Types of skin cancer in organ transplant recipients
In organ transplant recipients and other individuals receiving immunosuppressive therapy, several types of skin cancer occur more frequently than in people with normal immune function:
Squamous cell carcinoma
- The most common type of skin cancer in immunocompromised patients
- Occurs approximately 40 to 250 times more frequently than in the general population
- May grow rapidly and, in some cases, spread to lymph nodes
Basal cell carcinoma
- Occurs approximately 5 to 10 times more frequently than in the general population
- May develop in multiple locations on the body, most often on the face and upper body
Melanoma
- Risk is approximately 2 to 3 times higher than in the general population
- May develop earlier in life and can behave more aggressively
Squamous cell carcinoma occurs more frequently in organ transplant recipients than in individuals who are not receiving immunosuppressive therapy.
Monitoring and follow-up
Organ transplant recipients are typically offered regular skin examinations by a dermatologist to detect skin changes as early as possible.
The frequency of these examinations depends on an individual risk assessment, including:
- the type of transplant received
- the immunosuppressive medications used
- the duration of treatment
- personal history of skin cancer
During each visit, the entire skin surface is examined carefully. Follow-up care is coordinated between the transplant team and the dermatology team.
If you are unsure whether you are enrolled in a skin cancer surveillance program, you should contact your treating physician or transplant team.
Even if you attend regular skin examinations, it is important to monitor your skin yourself:
- Examine your entire skin once a month
- Use a mirror or ask for help to check areas you cannot see yourself
- Take photographs of spots or growths to monitor changes over time
- Contact your doctor if you notice new lesions or changes in existing ones
Regular self-examination and photographic monitoring can help detect skin cancer early.
Check your skin regularly. Taking pictures makes it much easier to make comparisons over time.
Photo: Colourbox
Other high-risk patient groups
Other individuals with weakened immune systems may also have an increased risk of skin cancer.
The level of risk depends on the cause of immune suppression, the medications used, and the duration of treatment.
Hematopoietic stem cell transplant recipients
Patients who have received a bone marrow or stem cell transplant have the second highest risk after solid organ transplant recipients, particularly if they develop chronic graft-versus-host disease and require long-term immunosuppressive therapy.
Patients with autoimmune diseases and other causes of immune suppression
Patients receiving immunosuppressive treatment for autoimmune diseases, such as lupus, have an increased risk of certain types of skin cancer.
Individuals with immune suppression due to other causes, such as HIV infection, also have an increased risk of skin cancer.