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EMBARGOED UNTIL MARCH 21, 1999

ORGAN TRANSPLANT PATIENTS AT HIGH RISK FOR DEVELOPING SKIN CANCER

NEW ORLEANS (March 21, 1999) - Each year, more and more people are enjoying a new lease on life with the increase of organ transplant surgeries. But studies find that organ transplant patients are more susceptible to developing skin cancer following surgery and need to take extra precautions to avoid prolonged sun exposure and monitor their skin for any signs of change.

Speaking today at the American Academy of Dermatology's 57th Annual Meeting in New Orleans, dermatologist Clark C. Otley, MD, Mayo Clinic, discussed the high occurrence of skin cancer in transplant patients and the need to educate patients on the risk of developing skin cancer following transplant surgery.

"Approximately 35 percent to 70 percent of organ transplant patients develop skin cancer within 20 years following transplant surgery, depending on geographic location," said Dr. Otley. "Even more alarming is that some long-term transplant patients actually die from skin cancer."

While many factors such as ozone depletion, immunosuppression due to heavy doses of post-surgical medication, human papillomavirus (HPV) - the virus that causes warts - and a steady rise in melanoma over the years contribute to whether or not an organ transplant patient will develop skin cancer, past sun exposure is one of the main risk factors. Dr. Otley finds that lighter skin patients with a history of sun damage are more susceptible to developing skin cancer following transplant surgery than darker skinned patients.

"Prior sun damage combined with immunosuppression is a recipe for disaster," said Dr. Otley. "We're seeing patients with hundreds of skin cancers developing per year following transplant surgery. This can ruin a person's quality of life."

Although all transplant recipients are at greater risk for developing skin cancer than the general population, skin cancer is more prevalent in heart transplant patients than kidney transplant patients. A study published in the January 1999 issue of the Journal of the American Academy of Dermatology tracking the incidence of skin cancer in Australian heart transplant patients concluded that heart transplant patients traditionally require "higher doses of immunosuppression agents compared with other solid organ transplants."

Skin cancer is classified into three categories - basal cell carcinoma, squamous cell carcinoma and malignant melanoma. While 80 percent of the estimated 1 million new cases of skin cancer that will be diagnosed in the United States each year will be basal cell carcinoma, research finds that squamous cell carcinoma is much more prevalent in transplant recipients.

"Squamous cell carcinoma poses a significant threat to transplant patients because this type of cancer can metastasize, or spread to other parts of the body, and can be quite aggressive in immunosuppressed patients" explained Dr. Otley. The American Academy of Dermatology estimates that 1,200 people died of squamous cell carcinoma in 1998.

For patients with rampant skin cancer following an organ transplant, chemoprevention, or using chemicals to prevent the growth of new skin cancers, with oral retinoids has proven effective in studies. "Acetretin, which is actually an oral medication that is effective in treating psoriasis, seems to prevent the growth of new skin cancers in patients that experience an aggressive growth of skin cancers following transplant surgery," said Dr. Otley. "This allows us to try to treat the existing cancers with traditional therapies."

Dr. Otley recommends that transplant patients follow the American Academy of Dermatology's sun protection guidelines, including avoiding outdoor activities between 10 a.m. and 4 p.m. when the sun's rays are the strongest, seeking shade whenever possible, wearing a broad spectrum sunscreen with a Sun Protection Factor (SPF) of at least 15, and wearing sun protective clothing. Dr. Otley advises transplant patients to learn to perform frequent skin self-examinations and report any suspicious changes in moles or new lesions to their dermatologist.

The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership over 11,000 dermatologists worldwide, the Academy is committed to: advancing the science and art of medicine and surgery related to the skin; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care; and promoting a lifetime of healthier skin, hair, and nails. For more information, contact the AAD at 1-888-462-DERM or www.aad.org.

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