A Novel, Unified Approach to Cancer and Transplant Care

Treating transplant patients with cancer can be a challenging, siloed effort. The pioneering Cancer and Organ Transplant Clinic (COTC) brings together oncologists and transplant specialists to provide better clinical care and outcomes for patients facing these complexities. 

Christopher Blosser, MD
Christopher Blosser, MD

Led by Christopher Blosser, MD, of UW Medicine, the multidisciplinary COTC is the first clinic of its kind. 

“I was inspired to start the COTC because I saw a gap in care for these patients and an opportunity to develop a more collaborative approach,” says Dr. Blosser. “So far, our strategy has been successful. We’ve helped patients who have had multiple transplants and resistant cancers get back to the activities they enjoy.” 

Challenges of patients facing cancer and transplant 

People with cancer are living longer than ever, increasing the chance they need an organ transplant at some point. And people who have received an organ transplant have a two to four times higher risk of developing cancer.

The optimal treatments for cancer and transplant work against each other:

  • Immunotherapy, often a preferred cancer treatment, turns on the immune system to attack the cancer.
  • Transplant recipients receive lifelong medications to suppress their immune system to prevent organ rejection. 

These conflicting goals can lead to poor outcomes and serious side effects, including transplant rejection. At times, patients need to make difficult decisions about whether to prioritize cancer treatment or transplant function. The need to navigate multiple diseases, doctors and medications can be overwhelming for patients and their families. 

Coordinated care for patients with cancer and transplant

Dr. Blosser established this innovative clinic in September 2021 to provide personalized and integrated cancer and transplant care. The COTC offers a streamlined consultation process:

  • Each patient sees cancer and transplant specialists specific to their condition during the same visit.
  • The specialists review the case and discuss the patient’s concerns and goals.
  • A real-time tumor/transplantation board meets to develop a recommended treatment plan
  • Immediately after the meeting, the specialists share their recommendations with the patient and referring providers.
  • Patients take home an audio recording of the specialists’ recommendations and related discussions. 

The complex issues COTC specialists typically consider include:

  • What are the best cancer treatments for future organ transplant recipients?
  • What types of cancer therapy — including immunotherapy — and transplant-focused immunosuppression are best for transplant recipients with cancer?
  • What is the safest time for organ transplantation for patients after undergoing cancer treatment?

Following the initial visit, patients receive coordinated, state-of-the-art care at FHCC and UW based on their specific cancer and transplant needs. 

Combining clinical care with state-of-the-art research

While the COTC applies leading-edge strategies for patient care, more research is needed to move the science forward. Toward that end, the COTC is part of UW’s Center for Innovations in Cancer & Transplant (CICT), led by Dr. Blosser, which is catalyzing research to provide new options for patients and doctors. 

The CICT also leads the only active national bio-registry that collects data from both cancer centers and transplant programs. This data enables research across multiple cancer types and transplant conditions. CICT researchers focus on three areas:

  • Patient-reported outcomes of patients with cancer and organ transplant, including the impacts of social determinants of health and racism. 
  • Epidemiology of cancer and organ transplant.
  • Translational research to accelerate the detection and treatment of cancers in the high-risk transplant population.

How to refer a patient

“Patients, researchers and clinicians can all benefit from our combined approach to clinical care and research,” says Dr. Blosser. “We encourage clinicians and fellow researchers to refer patients, submit data and collaborate on high-end research. Together we can build better cancer and transplant solutions.”

For patient referrals, contact:

Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.