Skin Cancer Skin cancer is the most common type of cancer in the U.S. This year, the Skin Cancer Foundation estimates more than one million Americans will be diagnosed with skin cancer. One in five will develop it in their lifetime.

The most common form of skin cancer is basal cell carcinoma. These cancers form in the basal cells, or those in the bottom-most part of the epidermis (the outer layer of skin). They are most commonly caused by excessive exposure to the sun. Thus, the areas of the body affected tend to be the face, ears, neck, scalp, shoulders and back.

Squamous cell carcinoma is the second most common type of skin cancer. These cancers form in the squamous cells (those found in the upper layers of the epidermis). As with basal cell carcinoma, squamous cell skin cancers most commonly occur in areas of the skin that receive the most sun exposure. Sometimes squamous cell carcinomas can spread into underlying tissues or distant sites of the body.

Melanoma is the least common of the three main types of skin cancer, but it is the most serious. The cancer forms in the melanocytes, the specialized cells that produce pigment (melanin) and give skin its color. Incidence of melanoma is rising. In 2010, the Skin Cancer Foundation projects one in 50 Americans will develop melanoma. Melanomas can be deadly because they may quickly invade underlying tissue and spread to other areas of the body. The most common sites for melanoma are the trunk, legs, arms and scalp.

Skin Cancer in Transplant Patients Between January and October 2005, more than 23,500 transplants were performed in the U.S. (date from the United Network for Organ Sharing, or UNOS). Today, with better monitoring, care and use of immunosuppressant drugs (to prevent rejection of the donor organ), transplants tend to be highly successful, with many recipients living 5 years or more after their transplant.

But immunosuppression also comes with a price. While the medications effectively suppress the immune system to prevent rejection, the drugs aren't selective. So the part of the immune system that normally identifies and destroys foreign substances (like a virus), is also suppressed. So is the ability of the body to identify and eliminate cell mutations that can develop into cancer.

According to the International Transplant Skin Cancer Collaborative, up to 45 percent of transplant patients develop some form of skin cancer ten years after their transplant. About 80 percent develop skin cancer after 20 years. The most common form of skin cancer in transplant patients is squamous cell carcinoma. In fact, transplant recipients taking immunosuppressive medications are 65 times more likely to develop squamous cell carcinoma than the general population. Some transplant patients may only develop a few skin cancer lesions, while, over time, others may develop hundreds of them.

Reducing the Risk of Skin Cancer in Transplant Patients Sunscreens are recommended for all Americans (healthy and transplant patients alike) to reduce the risk of skin damage caused by exposure to the sun's UV rays. When used as recommended, sunscreens can lower the risk of developing skin cancer. But the topical agents only serve as a layer of protection. Once the skin has been exposed to harmful UV rays, sunscreens can't repair the damage.

Researchers at the University of Alabama at Birmingham, are testing a new cream they hope will repair damage to the skin's DNA caused by the sun. The "morning-after cream" (as it has been dubbed) contains the drug dimericine®. It is applied to the skin once a day to any areas that have been exposed to the sun. Dermatologist, Craig Elmets, M.D., says the cream contains proteins that repair damaged DNA, hopefully preventing the affected cells from developing into skin cancer.

The cream was tested on a group of patients with a genetic susceptibility to skin cancer (a condition called xeroderma pigmentosum. Elmets says those preliminary studies showed the cream was safe to use (even on the face) and could protect against the development of new skin cancers.

The researchers are currently testing the cream in a larger group of kidney transplant patients. Eventually the cream may be beneficial for a wide range of people who are at risk of developing skin cancer.

Dr. Elmets is directing the national study. Other sites will include Emory University, University of Pennsylvania, University of Michigan and the University of California, San Francisco.

For information on the study: http://www3.ccc.uab.edu/show.asp?durki=78917

For information and statistics on skin cancer risk in transplant patients: International Transplant Skin Cancer Collaborative, http://www.itscc.org

For general information on skin cancer: American Cancer Society, http://www.cancer.org, or contact your local chapter Skin Cancer Foundation, http://www.skincancer.org

For general information on transplants: American Organ Transplant Association, http://www.aotaonline.org American Society of Transplantation, http://www.a-s-t.org UNOS (United Network for Organ Sharing), http://www.unos.org