As diabetics, we are all familiar with the daily, sometimes by the minute, attention needed when riding the roller coaster of blood sugar fluctuations. It can be exhausting. We also worry about the potential damage to and failure of the major organs in our body. We are lucky for all the advances in organ transplants—particularly kidney and pancreas.
Today, kidneys have a 98% success rate from a living donor and 94.8% rate from a deceased person. When I had my transplant back in 1987 the chances were much different. I had a living donor, my mother, but the chances of success were 60%.
The downside then and now is the lifelong cocktail of antirejection drugs required to prevent transplant rejection.
It is a well-known fact that transplant recipients of any organ have a higher incidence of skin cancers specifically related to the necessary medications that must be taken for the life or the transplant. Basal cell, squamous cell and melanoma are the most common skin cancers being treated in organ transplant patients. Melanoma is the potentially deadly skin cancer that is most feared. Sadly, melanomas are more likely to spread (metastasize) throughout the body in transplant patients as well as being more fatal in this population. Since immunosuppressive drugs reduce the response of the immune system to fight off infections it makes sense that it also makes the body more susceptible to cancers.
While many of us already have years of sun-damaged skin and may have already been treated for skin cancers it isn’t too late to protect ourselves. Unlike 50 years ago, today we have a much better understanding of the dangers of sun exposure and there are many products on the market to block the dangers of UVA and UVB radiation. Using sunscreen is just the beginning. One should also wear wide-brimmed hats, sunglasses and tightly woven, dark-colored, long-sleeved shirts and pants. OR, polyester and silk fabrics with a high sheen also reflect harmful UV radiation. Avoiding exposure to the sun is the best protection of all.
As a young man in the 70’s, I like most of my friends and family were unaware of the dangers of sun exposure. We could never turn dark enough. It was very common to slather on the baby oil mixed with iodine or Ban de Soleil to get that bronzed healthy look. Years later we came to understand how dangerous that was especially for those of us on immunosuppressants.
Twice a year visits with a transplant dermatologist are critical to catch cancers in the early stages, have them removed and discuss the many options for the treatment of previously aged skin as well as procedures to treat already formed cancers. This is extremely important as transplant patients have a 100-fold increase in the likelihood of having a squamous cell cancer versus a non-transplant patient.
Spots that look different than others on your body, or spots which have changed in size, shape, color or texture, and sores that don’t heal should be looked at by your doctor. Melanoma, basal cell carcinoma, and squamous cell carcinoma often start as changes on your skin. They may be new growths and/or precancerous lesions. These changes which might not start out as being cancer could become cancerous as time goes bye.
Over the years, I have required multiple surgeries to remove skin cancers from many parts of my body including those which have never seen the sun. To make matters worse, the circulation in the calve of my leg is compromised, so it takes longer for the wounds to heal. The last procedure required 40 stitches and took 120 days to heal. As a Leo and avid sun lover this has been life changing. I now take walks after the sun has set. When I’m outdoors I look for shade and wear lose fitting clothes that covers as much of me as possible. I love to swim but do so at the indoor pool in my building or after the sun goes behind the mountains when we are in Palm Springs.
Endless changes are part of the diabetic’s life and this is just one more to add to the list, but we do what we must to live the longest and healthiest life possible!