09. PTC: Cancer Risks for Pancreas Recipients
Why am I at greater risk of developing cancer after pancreas transplant?
Additionally, because immunosuppressant drugs reduce your body’s natural monitoring and disease response, you are at increased risk of developing certain viral infections that are linked to increased cancer risk. Examples of these viruses include the Epstein-Barr virus which is associated with lymphoma, Hepatitis which is linked to liver cancer, the Herpes virus which is associated with Kaposi sarcoma, and the Human Papilloma Virus that is associated with skin cancers. There is also a very small chance that cancer was already present in the transplanted organ.
Which cancers am I at greater risk for, and how high is my risk?
- Skin Cancer: According to Family Practice News, research has found that people who have received a Pancreas transplant have a cumulative incidence of skin cancer 10 years after transplant that is about 20%. This means that with each year after transplant, your risk of developing skin cancer increases up to 20% after 10 years. Another notable finding was that recipients who developed squamous cell carcinoma, a specific type of skin cancer, were 56% more likely to develop a second one within 2 years. People who developed a basal cell carcinoma, another specific type of skin cancer, were 36% more likely to develop a second one within 2 years. The risk of developing skin cancer after a pancreas transplant increases with age.
- Post-transplant Lymphoproliferative Disease (PTLD): Lymphomas are cancers of the white blood cells also known as PTLD. These can present in a single location or multiple locations, including the bone marrow, brain, digestive tract, allograft, or liver. Many cases of PTLD are associated with the Epstein-Barr virus, a member of the herpes virus family. Recent research from scientists at the University of Minnesota found that about 100 people or 5% of people in a study that had about 2300 people developed PTLD. Of that 5%, the most common time that it showed up was within 6 months of the transplant. One other thing that increased risk of PTLD was if the person had a history of rejection. Other research by Dr. Issa and colleagues found that order of transplant, like if you did kidneys first, or both at the same time, or just pancreas did not matter for the amount of risk of PTLD.