30 July 2018
MONDAY, July 30, 2018 (HealthDay News) — Organ transplant recipients are at increased risk for skin cancer and need to protect themselves, a dermatologist warns. “Individuals who receive organ transplants need to take immunosuppressive medications for the rest of their lives, and this makes it more difficult for their bodies to fight disease, including skin cancer,” said Dr. Christina Lee Chung. She is former director of the Drexel Dermatology Center for Transplant Patients in Philadelphia. “On top of that, some of these medications make the skin more sensitive to the sun’s harmful ultraviolet rays, which can further increase patients’ skin cancer risk,” she added in an American Academy of Dermatology (AAD) news release. Transplant patients with the highest risk of skin cancer include those with lighter skin, men and anyone with a pre-transplant history of skin cancer. If they received their new organ at age 50 or older, or had a lung or heart transplant, they are also at higher risk. “It’s important for all organ transplant patients, regardless of skin tone, to recognize their skin cancer risk,” Chung said. They need to avoid sun exposure, “which could further increase that risk, and regularly examine their entire body, including the genital area, for signs of skin cancer so they can detect the disease early, when it’s most treatable.” In addition, organ transplant recipients “should establish a relationship with a board-certified dermatologist after their procedure,” Chung recommended. “A dermatologist can evaluate your unique risk factors and help you ensure the health of your largest organ: your skin,” she said. Everyone should protect their skin from the sun by wearing protective clothing, generously applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to exposed skin, and seeking shade when possible, the AAD advises. The academy also recommends regular skin cancer self-exams, and asking a partner to help you check hard-to-see areas, including your back. If you notice any new spots, any suspicious spots that appear different from the others on your skin, or anything changing, itching or bleeding, see a doctor. More information The American Academy of Family Physicians has more on skin cancer.
23 April 2018
MONDAY, April 23, 2018 (HealthDay News) — The world’s first total penis and scrotum transplant was performed about a month ago on a U.S. veteran who was injured in Afghanistan, doctors say. “We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man,” said surgical team member Dr. W.P. Andrew Lee. He’s professor and director of plastic and reconstructive surgery at Johns Hopkins University School of Medicine, in Baltimore. According to a Hopkins news release, nine plastic surgeons and two urological surgeons conducted the 14-hour surgery on March 26. The transplant from a deceased donor included the entire penis, scrotum (without testicles) and partial abdominal wall. The surgery involved transplanting skin, muscles, tendons, nerves, bone and blood vessels. “It’s a real mind-boggling injury to suffer; it is not an easy one to accept,” said the recipient, who wishes to remain anonymous. “When I first woke up, I felt finally more normal [with] a level of confidence, as well. Confidence like, finally, I’m OK now,” he said in the news release. The man has recovered from the transplant surgery and is expected to leave the hospital this week. Speaking to The New York Times, the veteran described his anguish from his injuries, which occurred after he stepped on a hidden bomb. He lost both legs above the knee, but the genital injury was even more devastating. “That injury, I felt like it banished me from a relationship,” he told the Times last week. “Like, that’s it, you’re done, you’re by yourself for the rest of your life. I struggled with even viewing myself as a man for a long time.” He asked that his name not be published due to stigma surrounding genital injuries. Lee told the newspaper, “We’re hopeful we can restore sexual function in terms of spontaneous erection and orgasm.” However, the transplant recipient did not receive the donor’s testes as part of the transplant. Receiving those organs might have enabled the patient to go on to father children with the donor’s sperm, something deemed medically unethical. The patient is currently receiving testosterone to compensate for the lack of testes, as well as the erectile dysfunction drug Cialis, to encourage erectile function. As with any transplant surgery, rejection of the patient’s transplanted tissue is a concern, so he is also receiving immune system-suppressing drugs to reduce the risk of rejection. It’s possible to reconstruct a penis using tissue from other parts of the body, but an implant is necessary to enable erections, which poses a much higher risk of infection, Lee explained. Lee also noted that due to other injuries, soldiers often don’t have enough usable tissue from other parts of their bodies for penis reconstruction, so transplant was the only good option. The veteran in this case waited more than a year for a viable donor. The surgery is estimated to have cost between $300,000 to $400,000, but in this case Hopkins paid for the bill and the surgical team worked for free, the Times said. The exact need for these types of surgeries remains unclear, but the newspaper said that Department of Defense data shows that more than 1,300 men have sustained genitourinary injuries in Iraq or Afghanistan, with close to one-third of injuries involving the penis. The patient said he went through tough times emotionally after the injury, and kept the loss of his genitalia a secret from all but a few. “There were times you’d be hanging out and guys would be talking about getting hurt, and that’s one of the first things when they get blown up, to check down there, and they would say things like, ‘If I lost mine I’d just kill myself,'” he told the Times. “And I’m sitting there. They didn’t know, and I know they didn’t mean any offense, but it kind of hits you in the gut.” Thoughts of suicide crossed his mind, he said, but “when I would actually think about killing myself, I would think, ‘Am I really just gonna kill myself over a penis?'” So, he underwent physical therapy, learned to walk on prosthetic legs, and even earned a college degree in the years after the injury. He is now making plans to attend medical school. But intimate relationships seemed out of the question, because he feared disclosing his injury. However, the future looks brighter now, the man told the Times. His goals? “To do well in school, to go to medical school and follow my career as a doctor, find my niche in the field and just excel at it. Maybe settle down and maybe eventually find someone, and get into a relationship, maybe. Just that normal stuff.” More information The U.S. Centers for Disease Control and Prevention has more on explosions and blast injuries.