According to researchers who participated at the second European Lung Cancer Conference, it seems that after receiving a heart or liver transplant, recipients are exposed to a high risk of developing lung cancer. Doctors are advised to screen this type of patients for such cancers, in order to be able to detect the malignancy in time.
Doctors are already aware for decades that the immunosuppressive drugs that they prescribe to transplant patients increase the possibility of developing new cancers. Studies show that the risk of developing a malignant tumor in transplant patients ranges between 4% and 18%, but may even be 100-fold higher than in the general population. After transplantations, the most frequent malignancies are cancers of the skin and lips, Kaposi’s sarcoma or lymphoproliferative disorders.
French researchers have studied, on a recent project, the risk of developing lung cancer in patients who have suffered different types of transplants (solid organs). This is the largest and most important study to date which explores the development of lung cancer in transplant recipients.
The study has been made on 2,831 patients who have received organ transplants at Toulouse Hospital during a certain period: between February 1984 and September 2006. As a result, 0.85% of the transplant patients developed a lung cancer shortly after the intervention.
Dr. Julien Mazieres, the study coordinator, states that after kidney transplants, 10 lung cancers have developed (0.5%), 8 after liver transplants (1.3%) and 6 after heart transplantation (2.8%). He also declared that the difference is statistically significant.
Mazieres said that the high incidence of lung cancer in heart and liver transplant recipients in comparison to kidney transplant recipients may be due to most of these patients having a heavy smoking history. For heart-transplant patients, the average number of packs per year was 75.2, 40 for liver-transplant patients and 28.5 for kidney-transplant recipients.
Researchers claim that transplant recipients must be screened for expected cancers for which early detection and treatment are associated with better prognosis. The statement is particularly true for skin cancers.
Researchers also claim that doctors should also take into account screening for lung cancer. Dr. Mazieres says that a close follow-up including chest examination and X-ray is easy to do and also very useful. As a minimum requirement, physicians who take care of transplant recipients should keep in mind the increased risk of cancer and also integrate this risk factor in their follow-up to improve the survival chance for these patients.

Investigators from the University of Pennsylvania School of Medicine and Case Western Reserve University studied hepatocellular carcinoma (HCC), a type of liver cancer that is one of the leading causes of cancer death worldwide. Obesity, type 2 diabetes and metabolic diseases are associated with 30% of the cases of HCC.

John Lambris, Ph.D., the Dr. Ralph and Sallie Weaver Professor of Research Medicine at Penn and senior co-author of the study said “The connection between obesity and cancer is not well understood at this point”, but the researchers try to detect precancerous conditions related to diet through the development of blood tests.

Hepatitis B and C viral infections, exposure to the fungal toxin aflatoxin, chronic alcohol use, or genetic liver diseases represent the other 70% of HCC cases.

Only 10 to 20 percent of hepatocellular carcinoma can be surgically removed, if that option is not possible than death usually comes in three to six months. This type of liver cancer causes about 700,000 deaths worldwide per year.

The tests on high-fat and low-fat diet on mice proved that the strain called C57BL/6J was susceptible to non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma on a high-fat, but not a low-fat diet. The strain named A/J encountered no such susceptibility no matter the diet.

The diets lasted almost 500 days, at the end of these period, mice predisposed to develop cancer showed characteristics of NASH, like inflammation, fibrosis and even cirrhosis, but if they changed to low-fat diet, these outcomes were reversed.

“The reason these findings are so provocative is that it relates to diet and we now have a unique model we know will develop cancer,” says Lambris.

The work was funded by the National Center for Research Resources and the Charles B. Wang Foundation.