05. PTC: Cancer Risks for Heart Recipients

05. PTC: Cancer Risks for Heart Recipients

Updated 1/27/2020 JMG

         What are my risks?

As a heart transplant recipient, you are at increased risk for skin cancer and some other less common cancers. This is because while life-sustaining, long-term use of immunosuppressant drugs lowers the body’s ability to fend off certain cancers. When you are taking immunosuppressant drugs, your immune response is lowered, and this is what helps to prevent your body from rejecting your new heart. It also means that your body is less able to recognize and destroy cancer cells or infections that can cause cancer.

For all people, cancer risk increases as a natural part of the aging process. For heart transplant recipients, the risk increases with each year of immunosuppressant drug use. This means that the longer heart transplant recipients survive post-transplant, the greater the incidence of cancer. There are also certain lifestyle choices that can raise your risk of cancer, such as not getting regular exercise, smoking, or having a poor diet.

The facts:
  • Cancer is the leading cause of death for heart transplant recipients.
  • Studies indicate that heart transplant recipients are at 50 times greater risk of developing skin cancer compared to the general public.

         So I’m at higher risk...what do I do now?

Early detection, diagnosis, and treatment are constantly improving. Cancer is most treatable when caught early, so being proactive about your health screenings is especially important. 

Most heart transplant programs follow their patients for life and in semi-annual clinic visits. It is recommended that you see a dermatologist on a regular schedule (usually at least twice a year unless other factors indicate closer surveillance).  Your doctor can recommend proper screenings, and can teach you about early warning signs to be on the lookout for.

There are also certain lifestyle choices you can make to reduce your risk of cancer. Below you will learn how to make an action plan to stay healthy and manage your risk. But first, watch and listen to the following short videos by transplant medical specialists to gain more understanding of your risk as a heart recipient and what you can do to reduce your risk.

Overview

With the ultimate goal of catching cancers early when they are very treatable, the heart transplant patients surviving the longest are those that closely adhere to their transplant programs testing regimen.  Once the patient is in long term recovery, typically by the 9 month to 1 year milestone post-surgery, annual and semi-annual testing will catch some cancers that are beyond the everyday symptoms that are obvious.  A PSA test for men, as an example, is typically part of the annual blood testing which will raise alarms for prostate cancer.  But equally important are others, like the eye exams and dermatology visits that are recommended but left to the patient to schedule and complete on their own.  Typically  the clinic visit will include a verbal questioning about those 'outside' careful vigilence practices, but it is up to the patient  to give honest responses and to take those actions.  Some patients, either because of the testing expense or being too busy, fail to follow the team's proactive advice and pay the price in cancer issues that come up too late for easy and effective treatment.

Action Plan

        What can I do to decrease my risk of cancer risk?

While you may not be able to do anything about the increased risk of cancer associated with immunosuppressant drug use, you can make healthy lifestyle choices:
  • First and most important, follow your transplant team's advice and recommended precautions and healthcare screenings.
  • Follow your care team’s advice when it comes to sun exposure. Transplant medications can make your skin more sensitive to sunlight leading to skin cancers.
  • See a dermatologist regularly who specializes in treating transplant patients. A specialist will have a better understanding of your unique needs as a transplant recipient and can work with your transplant team to adjust medication dosages or propose different medication options to reduce the risk of skin cancers.
    • If you do develop skin cancer, your dermatologist can use a special pain-free procedure to completely remove the cancer. This is called a Mohs surgery and is a common procedure used with transplant patients.
  • If you are a smoker, commit to quitting. Quitting can be daunting, but there are many resources available to help you make a plan to quit and stick to it. Click here to learn more. [coming: a link to external resources and programs]
  • Eat a healthy balanced diet.
  • If you are overweight, consider trying to lose weight. For help, take a look at these resources. [coming: a link to external resources and programs]
  • Stay active. As approved by your physician, getting regular exercise has been linked to reduced cancer risk.

  Ready to check what you've learned?

  2020 01 27 224543

Next Steps:

  1. Learn the signs and symptoms for early skin cancer detection through this short description with example pictures: https://www.cancer.org/latest-news/how-to-spot-skin-cancer.html
  2. Learn more by watching the longer video [click here for that video] that gives an in-depth exploration of this subject. Note there are some graphic images included, which are intended to help you know what to look for and motivate you to take action.
  3. Use the closing link below to move to the LOOK section where topics addressing the more common cancer symptoms are explained.
  4. After reading about the symptoms, use the LIVE section to understand how to prevent, diagnose, treat and live long in recovering from cancer.
  5. Under the site's LINKS section, you can watch patient testimonials of transplant recipients living successfully with cancers of various types. There you will also find 10 Best Practices for living with the risks of post-transplant cancer, as well as an extensive list of online reading and video resources related to this important issue.

Most Common Post-Transplant Cancer Types

Updated: 7/20/2019 JMG

Each type of organ transplant comes with cancer risks that may be different due to unique biology of that organ, or more commonly, due to the different drug protocals - both drug type and dosage - used for each type of transplant.  

In this LOOK...

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    DISCLAIMER: The content of this TRIO post-transplant cancer Web site is not influenced by sponsors. The site is designed primarily for use by transplant recipients and their supporters. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with your transplant team or a physician skilled in cancer and your organ type if you suspect you are ill.