Long-Term Follow-Up

Skin Cancer



Q. Is my risk of getting skin cancer increased after transplant?

Yes, your risk of skin cancer is increased if you received radiation therapy either as part of the initial treatment or as part of the preparation for the transplant. The effect of radiation therapy is strongest among those who received that therapy before 18 years of age at the time of treatment, but anyone who has had radiation therapy is at increased risk. Also, acute and chronic graft-versus-host disease and the medications used to treat graft-versus-host disease increase the risk of skin cancers.

For basal cell carcinoma, lighter-skinned patients are at higher risk. For either basal or squamous cell carcinoma, patients who were under age 10 at the time of their transplant are at the highest risk. For more information, see skin health.



Q. What can I do to prevent skin cancer?

Avoid excess ultraviolet radiation that comes from the sun, tanning booths or sun lamps. This can be accomplished in several ways:

  • Reduce time spent in the sun between 11 a.m. and 3 p.m., when the light is strongest.
  • Take extra care in environments with sand, snow, concrete, water and high altitudes (such as pools, beaches and skiing) where the risk of sun damage caused by sun exposure is increased.
  • Do not use sun lamps or tanning booths.
  • Wear protective clothing (sleeves, hats) in the sun.
  • Always apply sunscreen before going out, even if there is cloud cover. Reapply sunscreen if you have water exposure or excessive perspiration. Use a sunscreen that has an SPF of 15 or greater
  • Do skin self-examinations regularly and report any changes to your doctor as soon as possible. Be sure that your doctor examines your skin during regular check-ups.

For more information, go to prevention 



Q. Is it OK to stop these prevention techniques once I am five years out from my transplant?

No, you should continue to practice these protective strategies no matter how long ago you had your transplant. Because of your transplant, your risk of skin cancer remains increased, and actually continues to increase with additional sun exposure over time.



Q. Where can I get more information on skin cancer?

There are many excellent Internet sites with good information on skin cancer.
Here are two we recommend:

What you need to know
Skin cancer



Q. How common is skin cancer?

About 1 million people in the United States are diagnosed with skin cancer each year.
For more information, see
Skin cancer facts 



Q. Is all skin cancer the same?

No. There are three main types of skin cancer.
Basal cell carcinoma is the most common, and also the most treatable type of skin cancer. Basal cell cancers seldom spread to other areas of the body, but some patients develop multiple independent cancers. Basal cell cancers usually occur in areas that have been exposed to the sun, most often on the nose. In patients who have received radiation therapy, basal cell cancers can appear anywhere in the radiation field. For patients who have had total body irradiation as part of their preparation for transplant, basal cell cancers can occur anywhere on the body.

Squamous cell carcinoma also occurs on skin areas exposed to sun, especially the face and the backs of the hands, but they can occur anywhere on the body exposed to radiation therapy. Squamous cell cancer is easily treated. If left untreated, squamous cell cancer can spread to other areas of the body.

Malignant melanoma is the most serious type of skin cancer. Melanoma often develops from a mole and can spread to other parts of the body. Melanoma is very difficult to treat once it has spread. For more details on different types of skin cancer, see:
Basel cell carcinoma
Squamous cell carcinoma
Melanoma

 

Q. What symptoms of skin cancer should I be watching for after transplant?

Watch for changes in the skin such as sore, irritated or crusty areas that won't heal, new bumps or moles, or moles that grow or change shape or color. Skin cancers are generally more common in areas of the skin that have been exposed to the sun, but they can occur anywhere on the skin, especially after total-body irradiation or GVHD treatment. For more information, go to:

SCCA-skin cancer