Elevate Your Health Colorado Skin cancer as a side effect?

After recovering from a heart transplant in 1999, Kaiser Permanente Colorado patient Michael Quintana, 64, knew he had been given a second chance. What he didn’t know was that his transplant put him at risk for another serious disease – skin cancer.
 
“I never knew I was at increased risk because of my transplant,” he says. But that changed when he received a call from a Kaiser Permanente dermatology surgeon who had some research to share.
 
“Skin cancer affects up to 70 percent of transplant patients,” says Nicole Annest, MD, a board-certified dermatologist and fellowship-trained skin cancer surgeon with Kaiser Permanente Colorado. “In fact, it’s one of the more common long-term side effects after transplant surgery because of the patient’s decreased immune system.”
 
Innovative screening program
Using Kaiser Permanente’s database of electronic medical records, Dr. Annest developed a cutting-edge skin cancer screening program for transplant patients.
 
By cross referencing electronic medical records with data from Kaiser Permanente’s transplant clinics, she compiles a list of transplant patients at the highest risk for skin cancer. The patients are then contacted to come in for a complete skin exam, as was the case for Quintana. “That’s when Dr. Annest noticed a spot on my face,” he says.
 
A biopsy of the lesion revealed precancerous cells, which were removed promptly. If the biopsy had demonstrated invasive cancer cells, the lesion might be treated by Dr. Annest using tissue-sparing Mohs micrographic surgery. Dr. Annest also took the opportunity to explain the importance of UVA/UVB sunblock. “Now, I am careful to apply sunscreen the right way – and to reapply it often,” says Quintana, who now uses SPF 30.
 
Get skin checked
“I have the opportunity to use our EMR system to help patients I have never even met,” says Dr. Annest, who is also a member of the International Transplant Skin Cancer Collaborative. “It’s my chance to remind them how important it is to get their skin checked – especially here in Colorado where the UV exposure is so high.” (NOTE: Link to Dr. Annest skin cancer prevention article from July)
 
In sunny locations such as Colorado, transplant patients have 65 times more risk for skin cancer when compared to the general population. Kaiser Permanente transplant patients are educated on their elevated risk. “Through the program, we have already diagnosed dozens ofskin cancers in patients that might have otherwise gone undetected,” Dr. Annest says. 
 
Quintana considers the program a life saver. “As soon as Dr. Annest started the skin screening program, she contacted me,” he says. “It felt pretty good to have someone watching out for my health.”
 
Are you or a loved one an organ recipient? Discuss the risk for skin cancer with your primary care physician and learn more about skin cancer prevention at kp.org.