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Post-transplant cancer needs more study

by Denise B. Hensley
Growing evidence has been identified that post-transplant cancer incidence may be increasing, especially among women, and likely can be headed off with proper new standards and screenings, according to an article invited by World Journal of Transplantation and recently published by a team from the Lynda K. and David M. Underwood Center for Digestive Disorders and the Houston Methodist Sherrie and Alan Conover Center for Liver Disease & Transplantation.   “It’s surprising and outdated that men and women are being managed the same when we know there’s a physiologic difference between the two.,” said Michelle Jones-Pauley, DO, transplant hepatology fellow. Jones-Pauley is the second fellow for transplant hepatology but the first after a three-year GI fellowship. In the fellowship, she works to manage patients up to transplant by “modifying any of the modifiable risk factors.”
Michelle Jones-Pauley, DO
She said it makes sense that cancer is increasing because of continually improving outcomes of solid organ transplant particularly the longer life expectancy for post-transplant patients. The need for post-transplant cancer surveillance is growing. “Transplant has become a larger field, especially for the Houston Methodist program, which has exploded in recent years,” she said.   Patients are living longer after solid organ transplant and are requiring long-term monitoring for malignancies. Growing evidence exists that breast and gynecologic cancers, specifically cervical and vulvovaginal cancers, may have a higher mortality rate in post-transplant patients. However, no consistent standard has been established among transplant societies for screening and identifying these cancers in post-transplant patients. Ultimately, further studies are needed to determine if more aggressive screening strategies would be of benefit for these cancers, the study says.   Breast, ovarian and endometrial cancers do not appear to have significantly increased incidence. However, the data on these cancers remains limited. Further studies are needed to determine if more aggressive screening strategies would be of benefit for these cancers.   Jones-Pauley plans to maintain a balance in clinical and research in her career with a heavy emphasis on patient care.