Organ transplants save lives, raise skin cancer risk

Organ transplants can be life-saving.  But they can also significantly raise your risk of skin cancer.

Heather Ludi of Decatur, Georgia, has grown used to being biopsied for skin cancer.

"The first times that I had it done, it was anxiety provoking because you hear the word "cancer,” Ludi remembers.  “You don't know.  Is it bad?  Did it spread?  That kind of thing."

 Ludi had a kidney transplant at 5 and then again at 22.  Now in her 40's, she takes anti-rejection medication and watches her skin carefully for new lesions.

"Now it's become pretty routine,” she says. “I know when I see one that I have to come in and get it checked out. And get it removed, so it's just part of being me."

The problem?  After  you undergo an organ transplant, you have to take medication to keep your body from rejecting and destroying your new organ. But that immune-suppressing medication can make you more vulnerable to sun damage. 

So, organ recipients are up to 70 times more likely to develop skin cancer than people who have not had a transplant.

"When we look and examine our organ transplant patients, they start to develop skin cancer, depending on their skin type, about 5 to 7 years after their transplant,” says Dr. Fiona Zwald of Dermatology Consultants.

The problem is so common among organ recipients, Dr. Zwald has created a special dermatology clinic at Piedmont Atlanta Hospital just for transplant patients.  She encourages them to check their skin often for new spots.

"Usually they're on the head and neck area, sun-exposed areas,” she says.  “So, face, ears, nose, back of the neck.  And the back of the hands."

Zwald tells patients to look for anything new on the skin.

"Especially if it's growing. Especially if it hurts. Especially if it bleeds," she says.

Ludi has had about 10 lesions biopsied.

For the malignant ones, Dr. Zwald performs MOHS surgery to remove the cancer bit by bit.

"What they do is take little spots and take more and more layers off,” Ludi says. “And they look at it under a microscope to make sure that the cancer is gone. And they do that several times, so you can spend 4 or 5 hours here in the clinic.”

Dr. Zwald says she is working with transplant specialists to try to find a way to lower the amount of anti-rejection drugs patients like Heather Ludi are prescribed.

For now, Ludi is a frequent-flyer in Zwald’s skin cancer clinic.  She’s no longer frightened of biopsies and everything that comes after them.

“It's all part of life for me, honestly,” she says.