What is post-transplant cancer?
Post-transplant cancer is cancer that develops in transplant recipients.
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Transplant recipients have a higher chance of cancer because of the immunosuppressant drugs they take. Immunosuppressant drugs lower (or suppress) part of your immune system, which are the cells, tissues, and organs that help your body fight infection and destroy cancer cells. When the immune system is suppressed, cancer can grow more easily.
Why do transplant recipients need immunosuppressants?
When someone gets an organ transplant, their immune system may try to protect their body by attacking the new organ as a foreign object (called transplant rejection). This is because our immune system fights infection and illness, but may sometimes attack cells they see as “foreign.”
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Transplant recipients take immunosuppressants to stop their body from attacking or rejecting their new organ. This helps keep their new organ healthy.
How do immunosuppressants raise the chance of cancer?
Immunosuppressants lower your immune system so it doesn’t reject your new organ. And a lowered immune system is less likely to:
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Find and destroy cancer cells
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Fight off infections that can cause cancer
Some recipients may have an even higher chance of cancer if:
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They take a high dose (amount) of immunosuppressants
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They take immunosuppressants for a long time
What cancers are transplant recipients especially at risk for?
Transplant recipients have an overall higher chance of cancer in general. But there are some cancers they are especially at risk for:
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Skin cancer
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Post-transplant lymphoproliferative disorder (PTLD)
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Virus-linked cancers
Skin cancer
Skin cancer is cancer that starts in your skin cells. Skin cancer is mostly caused by ultraviolet (UV) rays, such as from the sun or tanning beds
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Skin cancer is the most common type of cancer in transplant recipients. They are most likely to get these 2 non-melanoma types of skin cancer:
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Basal cell carcinoma – Transplant recipients are 10 times more likely to get this cancer.
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Squamous cell carcinoma – Transplant recipients are 65 times more likely to get this cancer.
Post-transplant lymphoproliferative disorder (PTLD)
Post-transplant lymphoproliferative disorder (PTLD) are diseases that happen when white blood cells multiply out of control. PTLD is considered lymphoma, or blood cancers, that usually affect people with Epstein-Barr virus (EBV).
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The Epstein-Barr virus (EBV) is a common virus that can spread easily. It can cause an illness called mono (mononucleosis) that is common in teenagers and young adults.
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If someone gets EBV, the virus stays in their body for the rest of their life, but their immune system keeps it inactive. For transplant recipients, immunosuppressants may lower their immune system’s ability to keep EBV inactive. If EBV becomes active again, it may cause certain types of blood cancers.
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However, some cases of PTLD are not related to EBV. It is not clear what causes these cases.
Different organ transplants have different rates of PTLD. But, anywhere from 1% to 20% (1 to 20 in 100) of transplant recipients get PTLD.
Virus-linked cancers
Transplant recipients may be more likely to develop cancers that are linked to viruses due to immunosuppressants. This is because these drugs make the immune system less likely to fight off viruses, and some viruses can lead to certain cancers.
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Most of these are viruses that stay in your body for a long time, even after symptoms have been treated. When a virus gets into your body, it uses your cells to make copies of itself. It does that by making changes to the cell itself. These changes can make the cells more likely to become cancerous. Different viruses can infect and then cause cancer in different parts of your body.