Organ transplants give many people a new shot at life, a second chance which they might not have had if not for this medical procedure. Life, though, is never quite the same again, and organ recipients have to take immunosuppressant drugs to keep their bodies from rejecting their new organs. By having their immune systems suppressed, however, organ recipients become more susceptible to various health conditions, including infections. Unfortunately, they are also a lot more vulnerable to developing cancer, as various studies have repeatedly shown, including four recent ones highlighted here.
1. Kidney Transplant Recipients and Melanoma
In 2005, a study conducted at the Penn State College of Medicine looked at the data of 89,786 kidney transplant recipients and compared it to the general population. Led by Christopher S. Hollenbeak, PhD, the study team found that kidney transplant recipients were 3.6 times more likely to get melanoma when compared with the general population. They also found that the risk continued to escalate with each passing year after transplant, at about 5% per year.
Published in Cancer, a journal of the American Cancer Society, the study also revealed that men had higher risk than women, and that their risk increased with age. Blacks, on the other hand, were 7 times less likely to get the condition as compared to other races.
Melanoma is the deadliest of the various types of skin cancer. Typical risk factors are sunburns, a weak immune system and family history of abnormal moles. Previous studies drawing a link between organ transplants and melanoma risk had been inconsistent, possibly because it was more difficult to spot trends due to the relatively low incidence rates of this particular cancer.
2. Kidney Transplant Recipients and 20 Different Types of Cancer
An article published in The Lancet in mid 2007 revealed that HIV / AIDS patients and kidney transplant recipients had a higher risk of developing some 20 different kinds of cancer as compared to the general population.
For kidney transplant recipients, they were almost 4 times as likely to get Hodgkin’s lymphoma, and they also had significantly higher risks for developing cervical cancer as well as cancers of the mouth, penis and anus. In addition, kidney recipients were 208 times more likely to get Kaposi’s sarcoma. This sounds alarming, until we realize that HIV / AID patients were 3,640 times more likely to get this disease.
The key probably lies in compromised immune systems and the susceptibility of both groups of people to viruses. “The only thing that people with AIDS and transplant recipients share is immune deficiency, otherwise their risk factors for cancer differ markedly. In other cancers, which are not linked with viruses, such as breast and prostate cancer, both groups had similar rates to the general population,” said Professor Andrew Grulich from the University of New South Wales’ National Centre in HIV Epidemiology and Clinical Research (NCHECR), who led the study. Indeed, according to him, “this evidence suggests that immune deficiency is associated with risk of cancer”.
3. Liver Transplant Recipients and Various Types of Cancer
A study in Finland which was published in the October 2008 issue of Liver Transplantation found that liver transplant recipients were 2.59 times more likely to get non-Hodgkin’s lymphoma, while their risks for non-melanoma skin cancer and basal cell carcinoma were also significantly raised.
The study, led by Helena Isoniemi from Finland, examined 540 cases of liver transplant patients from Helsinki University Central Hospital who had received their new organs between 1982 and 2005. It also used data from the Finnish Population Register as well as the national Cancer Registry.
“Based on our data, one out of six liver transplant patients is estimated to develop some form of cancer by 20 years after transplantation. This study points out the importance of cancer surveillance after liver transplantation,” said the study team.
4. Liver Transplant Recipients and All Types of Cancer
Most recently, a population-based cohort study in Canada found that liver transplant recipients were at higher risk (about 2.5 times) for cancer, especially non-Hodgkin’s lymphoma and colorectal cancer, when compared to the general population. It also found that the higher risk was more pronounced among younger recipients as well as during the initial year after the procedure.
The study team, led by Ying Jiang from the Public Health Agency of Canada, looked at information from the Canadian Organ Replacement Registry as well as databases of the national mortality and cancer incidences. Persons who had liver cancer and those who had been diagnosed with any kind of cancer (excluding non-melanoma skin cancer) before or in the immediate 30 days after they received their new organs were excluded.
2,034 transplant recipients who had received new organs between June 1983 and October 1998 were tracked for up to 15 years, and it was found that their risk of any cancer was about 2.5 times that of the general population. According to the study team, this figure is lower than what previous studies had estimated, with a possible reason being that liver cancer and non-melanoma cancer patients were excluded.
“A striking finding in our study is the approximate twenty-fold increased risk of non-Hodgkin’s lymphoma among liver transplant patients relative to the general population. As a proportion of all cancers, it represented 55.8 percent of the absolute excess number of cancers among liver transplant patients,” said the study team. The increased risk for colorectal cancer could possibly be because of inflammatory bowel disease being more prevalent among transplant recipients.
Published in the November 2008 issue of Liver Transplantation, the study’s conclusion was clear. “Our findings firmly support an increased incidence of cancer in this patient population.”
The Bottom Line
The findings of these and other studies differ somewhat in that they point to different types of cancer and varying risk profiles for different groups of people. But for organ transplant recipients, the message is quite clear and coherent – there is the need for them to take even better care of their bodies than the average person in order to ward off diseases.
And for the rest of us, these research results also reaffirm the importance of the immune system in fighting off cancer – any type of cancer. Reducing our intake of substances which compromise this wonderful system – this includes both from our food and from chemicals found in everyday products such as soaps and shampoos, as well as investing in top quality immune-boosting foods and supplements would thus be important measures we can take to safeguard our health.
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