A patient who has received a solid organ transplant is at increased risk for a de novo malignancy.
Many of the cancers appear within 5 years of the organ transplant.
Types of cancers include:
(1) colon cancer
(2) non-small cell lung cancer
(3) breast cancer
(4) prostate cancer
(5) bladder cancer
(6) renal cell carcinoma
(7) malignant melanoma and other skin cancers
(8) posttransplant lymphoproliferative disorders
The main predisposing factor is aggressive immunosuppression.
Prognostics factors:
(1) late stage of the cancer at diagnosis
(2) aggressive tumor growth
(3) poor health status
A patient who has had a solid organ transplant should be monitored for signs of an occult malignancy, since early detection and treatment can be lifesaving.
(1) Colonoscopy should be performed regularly.
(2) The entire skin surface should be examined for skin lesions that should be monitored or biopsies.
(3) Hematuria should be investigated.
(4) Males should have an annual prostate exam.
(5) Females should have regular examinations for breast cancer.
(6) Patients with a history of significant smoking should be monitored for lung cancer.
