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Cancer screening is unavoidable after a transplant because of your immunosuppression medication. But why is this, what is happening in the body and what do you need to watch out for? Should you be worried now? You will find the answers to these questions in this article.
Here's what you need to know
Das solltest du wissen
Ecco cosa c'è da sapere
Voici ce qu'il faut savoir
Esto es lo que debe saber
  • Due to the weakened immune system caused by the immunosuppression drugs, regular cancer screening examinations and cancer prevention after transplantation are particularly important
  • Examinations that should be performed regularly for cancer prevention are blood tests, ultrasound examinations, colorectal cancer screening, skin cancer screening, as well as gender-specific examinations (e.g., cervical cancer, prostate cancer)
  • You can also contribute to early cancer detection by observing and palpating your body: the ABCDE rule helps you to detect skin cancer 
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Taking immunosuppressants is vital for you after the transplant. Immunosuppressants are a group of drugs that slow down the reactions of your body's defense system (=immune system) and thus ensure that your new kidney can be accepted by your body. 

At the same time, the helpful functions of your immune system are of course severely restricted by these drugs. This means that your immune system has a hard time recognizing and fighting older cells or cells that are suspected of being cancerous. It is therefore all the more important that you protect your body from possible risks by regular check-ups with your doctor.

Which cancer screening examinations are recommended?

Unfortunately, as is often the case, there is no general answer to the question of exactly which cancer screening examinations should be performed at which intervals after a transplant. Factors that play a role in this context are, above all, possible previous illnesses and the presence of certain risk factors. It is best to ask your attending physicians about this. Together you can draw up a customized examination plan for all the necessary preventive examinations. This way, no important examination will be forgotten!

Regardless of risk factors and age, there are examinations that are generally recommended for you. These include an annual ultrasound (=sonography) of the abdominal cavity including your transplanted organ. This allows your doctor to check whether any abnormalities are visible in your organs. Your own kidneys, lymph nodes and liver are examined in particular detail. Regular skin cancer screening is also recommended.

In addition, regular checks of your blood values are important, as some types of cancer can be detected at an early stage on the basis of laboratory values (e.g. PSA in the case of prostate cancer).

Further important preventive examinations are summarized for you in the next sections.

Never forget: You don't have to take care of everything on your own. If something is unclear to you or you have questions, contact your doctor. Together with you, they will find a solution for how you can best protect yourself against secondary diseases and which examinations are necessary for this. In this context, it is also important that you pay attention to changes in your body yourself and consult your doctor promptly if you notice any abnormalities (=symptoms) or complaints.

Which cancer screening tests are recommended specifically for women?

1. Pap smear 

As a woman, it is important for you to have regular cervical examinations. For this purpose, a cervical smear is taken and examined for changed cells. Depending on your age and the type of examination, you should have it done once every three years to annually.

2. Examination of the genitals

In addition, women should have an examination of the female genitals and sex organs once a year. During this screening, the visible area of the labia, vagina and cervix is examined first. Then the cervix, cervix and uterus are checked for possible changes from the outside through the abdominal wall and from the inside through the vagina.

For the final examination of the internal genital organs, gentle aids are usually used, which help your doctor to examine poorly visible areas more closely. This examination may sound a bit unpleasant, but you don't have to worry. It is absolutely painless and helps you to react to possible changes at an early stage.

3. Breast cancer

Depending on your age, you should also have a breast cancer screening every year or every two years. During this examination, the glandular tissue of your breast is palpated and examined for possible hardening and lumps in the tissue. Did you know that there are ways that you, as a woman, can regularly palpate your breasts yourself to detect changes?

The best thing is to talk to your gynecologist about it and let him explain it to you! It doesn't take long and you can incorporate this method regularly, for example, when showering. After the transplant, depending on your age and other risk factors, a mammogram, i.e., imaging for early detection of breast cancer using X-rays, may also be recommended every 1 to 3 years. Your medical team will discuss with you how often you will ultimately need a mammogram.

4. Colorectal screening

Another test you should have regularly is colorectal cancer screening. Through a laboratory examination once or twice a year, your colon and rectum can be examined for blood in the stool. In this way, colorectal cancer can be detected at an early stage. This examination is totally uncomplicated for you. You only have to give a tiny stool sample, which your medical team can examine.

In general, colorectal cancer screening in the form of a complete colonoscopy (examination of the colon) is recommended for everyone over the age of 50. Sometimes it is even recommended at a younger age. How often the examination should be repeated and whether you should start earlier depends on many individual factors and is the decision of your medical team.

Which cancer screening tests are recommended specifically for men?

1. Prostate screening 

As a man, regular screening examinations against prostate cancer are very important. They first involve checking the external genital organs. This is followed by palpation of the prostate and the lymph nodes in the groin. In addition, the PSA (=prostate specific antigen) is often determined in the blood. If no abnormalities are found, you are done. The examination is quick and painless. So you don't have to worry about this. Do you have doubts or are you too proud? Put it aside, it is very important for your health!

2. Colorectal screening 

In addition, as a man, you are also recommended to have a laboratory-based colorectal cancer screening by having a laboratory-based test for blood in the stool. This is recommended, as it is for women, starting at age 50 at intervals of 1 to 2 years.

As mentioned above, colonoscopy is also part of the classic screening for colorectal cancer and is generally recommended for people aged 50 and older.

How can I prevent skin cancer?

Unfortunately, taking immunosuppressants can make it easier for skin cancer to form after your transplant. But this is no reason to panic. There are several pieces of advice you can follow to reduce the risk of developing skin cancer and to respond early to abnormalities and changes.

An important part of skin cancer screening is prevention. You can protect yourself from direct sun exposure by using high SPF sunscreen and wearing head and body coverings or long-sleeved clothing. Nonetheless, you should avoid spending too much time in direct sunlight if possible when you are transplanted.

In addition, 1-2 times a year check-ups with your dermatologist or family doctor are recommended. These help to detect changes at an early stage. The earlier something is detected, the better and easier it is to react. But not only dermatologists can detect malignant discolorations: with a little practice, you yourself can also identify conspicuous skin areas and report them to your medical team if you have any doubts.

All you need are your eyes and, if necessary, a mirror and/or a second person for skin areas you can't easily see. The ABCDE rule summarizes the most important characteristics for you. If any of these apply to a mole on your body, it's best to make a follow-up appointment with a dermatologist as soon as possible:

A = Asymmetry; e.g., not round or oval, but rather irregular in shape.
B = Blurred or irregular borders at the edges
C = Different colors and shades (color) in one birthmark
D = Diameter > 5 millimeters
E = Rapid evolution (changes and/or growth) in the last 3 months

It is best to try it out for yourself and check yourself according to this rule. If you have any questions, your dermatologist will be happy to help you and explain the steps again. Of course, such a self-examination is no substitute for an examination by your supervising medical team.

Medically reviewed by:
Medizinisch überprüft durch:
Verificato dal punto di vista medico da:
Médicalement vérifié par :
Médicamente comprobado por:
Dr. Diego Parada Rodriguez (en)
Specialist in training for Nephrology
  • Manual zur Vereinheitlichung der Evaluation vor Nierentransplantation und Nierenlebendspende, der Wartelistenführung vor Nierentransplantation und zur Nachsorge nach Nierentransplantation und Nierenlebendspende. Abgerufen am 25.10.2022
  • Tumorvorsorge nach der Transplantation. Abgerufen am 25.10.2022
  • Das Tumorrisiko reduzieren. Abgerufen am 25.10.2022
  • Krebsvorsorge: Informationen & Ärzte für die Krebsvorsorge. Abgerufen am 25.10.2022
  • Krebsfrüherkennung (Krebsvorsorge) in der Krankenversicherung. Abgerufen am 25.10.2022
  • Gynäkologische Krebsfrüherkennung. Abgerufen am 25.10.2022
  • Prostatakrebs-Vorsorge – Untersuchung zur Früherkennung von Prostatakrebs. Abgerufen am 25.10.2022
  • Au E, Wong G, Chapman JR. Cancer in kidney transplant recipients. Nat Rev Nephrol. 2018 Aug;14(8):508-520. doi: 10.1038/s41581-018-0022-6. PMID: 29802400.
  • S3-Leitlinie Kolorektales Karzinom; Langversion 2.1. – Januar 2019; AWMF-Registernummer: 021/007OL
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