The Link between Organ Transplants and Melanoma
Melanoma accounts for only 2 percent of all skin cancer cases in the United States; however, it is the most serious form and results in the majority of skin cancer deaths. It is the fifth leading cancer in men and the seventh in women and it is estimated that 73,870 new cases of melanoma will be diagnosed in the U.S. in 2015, and that it will kill nearly 10,000 people. The rapid increase in the number of cases and high mortality rate has driven researchers to develop a more comprehensive understanding of the risk factors.
A new study co-authored by Hilary A. Robbins from the Johns Hopkins University Bloomberg School of Medicine in Baltimore, Maryland, suggests that patients who have an organ transplant are, for reasons not yet clear, twice as likely to develop melanoma and are at even greater risk of succumbing to the disease than individuals who have not undergone organ transplantation. The study also revealed the intriguing finding that organ transplant recipients were more likely to be diagnosed with melanoma in its later stages, which contradicts the previously held belief that more instances of melanoma were detected in transplant recipients simply because they were subject to more intensive screening.
The study showed that in fact the greatest increase was not for localized melanomas that are likely to be detected during screening, but rather for regional-stage melanomas that have already begun to spread. One factor considered likely responsible for the increase in the incidence of melanoma among transplant patients is the presence of immunopressive drugs. These drugs are, of course, required treatment for all transplant patients in order to help prevent the body from rejecting the transplanted organ, and patients must take them for their entire lives. Based on this study, we now know that more intensive melanoma screening for organ transplant patients, both before and after surgery, is imperative. Dr. Robbins said, “Closer dermatological monitoring of transplant recipients, particularly within the first 4 years after transplantation, could enable earlier detection of melanoma and help prevent patients from developing metastatic disease.”
In summary, the conclusion reached by the study is that melanoma is not only more common in patients who had received a transplant, but that the risk of mortality is greater because the disease behaves more aggressively in the presence of transplant-related immunosuppressive drugs.
The old adage that “it is better to be safe than sorry,” arguably applies to everyone when it comes to screening for melanoma, but it most definitely applies to transplant patients who should have regular dermatological checkups in order to detect this terrible disease as early as possible.