Disclaimer: To protect patient privacy, this question has been edited slightly to omit identifying details.
A Patient Power user with chronic lymphocytic leukemia (CLL) said, “I’ve been on watch and wait for five years, and I’m increasingly having skin problems, requiring Mohs surgery four times in the past 12-18 months. This includes squamous cell carcinoma and isolated melanoma. Is my CLL contributing to these skin problems? If so, should I consider beginning treatment for CLL to reduce these skin problems?”
Expert Response
“This is an excellent question,” said Kerry Rogers, MD, from The Ohio State University Comprehensive Cancer Center – The James. “Having CLL increases risk for skin cancers, and other cancers as well.”
You may be wondering why. “This is because having CLL makes your immune system work less well, and your immune system is what protects you from cancers by killing abnormal cells that could become cancers in the body,” Dr. Rogers said. “This increase in skin and other cancers is seen in people with CLL, as well as people who have other conditions that suppress the immune system, such as organ transplant recipients who are on immunosuppressive medications.”
Unfortunately, treatment is not straightforward, and moving out of watch and wait may not be a solution. “The bad news is that treating [your] CLL does not decrease this risk,” Dr. Rogers said. “In fact, CLL treatments decrease the immune system further and tend to increase this risk for other cancer as well as infections.”
So what should you do? “You should definitely talk to your hematologist,” said Dr. Rogers, “but in general, skin cancers are not a reason for [initiating] CLL treatment.”
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