Organ Transplant Recipients at Greater Risk for a Variety of Cancers

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Three. That's the number of kidney transplants Irene Schneider has received so far in her lifetime. Each new kidney has allowed her to skirt a potential lifetime of dialysis, or even death.

When doctors found a "massive" tumor plaguing Schneider's body shortly after her birth, it had already caused so much kidney damage that they gave her 15 years to live.

"I was a rickety kid," she said. "My parents always made an effort to reinforce my self-image through an organ that worked — my brain."

Now, at 61, Irene Schneider, an executive editor at Conde Nast Traveler, has outlived her doctors' predictions threefold, with a total of 35 surgeries under her belt.

When she was 34, Schneider received her first kidney transplant from her brother. Ten years later, that kidney started failing and Schneider's sister donated hers, which functioned for 15 years. When Schneider needed a third kidney, more than 20 people offered to be the next donor. Two years ago, she received her newest kidney from her brother-in-law. While other family members were a match, Schneider's body had begun developing antibodies to her family's own gene pool.

The new kidneys have kept her alive, but they also put her at greater risk of other fatal diseases. Soon into adulthood, doctors warned Schneider that a weakened immune system, brought on by the transplants, results in an elevated risk of certain kinds of cancer. Doctors said she was at particular risk for uterine, skin and breast cancers.

"I thought, 'Thank you for telling me that,'" said Schneider. "I've always wanted clarity, even if it's bad news. I like things to be as clear as possible."

While organ transplants are a lifesaving procedure, most transplant recipients are far from finished with hospital visits once the new organ is successfully accepted into the body.

As a young woman, Schneider received several biopsies — all negative — before doctors called her in for a follow-up biopsy in 2003.

"Finally, it happened," she said. "I said to them, 'OK, now let's deal with it."

Oncologists removed the cancer from her breast and she has remained in remission for six years. A hysterectomy spared Schneider the risk of uterine cancer, she said.

Schneider is certainly not the only patient to receive a cancer diagnosis after a transplant. And now, a new study, published Tuesday in the Journal of the American Medical Association, confirmed the risks that Schneider, and so many other patients are warned about. Researchers from the National Cancer Institute found that patients like Schneider are at twice as much risk of getting cancer than the general population.

"Transplants are truly one of the miracles of modern medicine," said Dr. Eric Engels, a senior investigator of the National Cancer Institute and lead author of the study. "But a weakened immune system certainly plays a role in organ transplant patients being at risk of cancer."

The study examined more than 175,000 organ transplants performed in the United States, which made up nearly 40 percent of all transplants procedures between 1987 and 2008. Recipients were at twice as much risk of the general population for developing cancer.

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