Since having cancer, I think about emergencies and end-of-life issues probably more than other folks. I’m still in the process of getting organized per my previous post, Exit Strategy, trying to plan for potential future health crises, updating my will and my retirement savings plan, giving my friends extra keys to the house, etcetera and so forth. I’m not yet due to renew my driver’s license, but I checked, just in case. And like many other people, I specified myself as an organ donor on my license a long time ago.
About a decade or so ago, I met a woman whose ten-year-old daughter developed cancer and liver failure from chemo. Her cancer was in remission, but she desperately needed, among other things, a liver transplant. A donor liver became available, it was a match, the tissue was carefully tested, and the transplant took place. It went well. Her little girl survived, tolerated the anti-rejection meds, began to regain some of her health, and then, unexpectedly, died. Apparently, the liver she had received contained cancer cells. Because her immunity was suppressed by the anti-rejection drugs, her T cells and other cells could not identify and fight these occult cancer cells, so the cells rapidly turned into full-blown cancer, and robbed her young life. They were able to determine that the liver cancer was not mets that might have developed from the cancer she’d been treated for. It more than likely came from the donor. It was devastating.
So, I looked at my license, and remembered this little girl. And wondered, would anyone want my organs anymore? I would never, ever want to donate an organ that transmitted a deadly legacy. Do I just forget about donating anything now that I’ve had cancer? I assumed so, but I decided to do a little research.
Turns out it’s not as cut-and-dried as I thought.
The American Red Cross lists eligibility requirements and other details for blood donation on their site. Some of them surprised me. Did you know that, if you are a woman, in order to donate red blood cells, you have to be at least 5’5″ tall and weigh at least 150 pounds? For other blood components, you have to be at least 17 and weigh at least 110 pounds. Just adding a little edit here, on 4/4, to clarify this a little. If you are female, you don’t have to be 5’5″ or weigh any more than 110 pounds to donate blood; they can use everything — white blood cells, platelets, etc. — but the red blood cells if you are shorter than that or weigh less than 150 pounds. These are also the requirements for the American Red Cross. Many other organizations do blood drives and may have different requirements.
The American Cancer Society lists the precautions that apply to cancer patients. From the site:
While cancer has very rarely been transmitted through transplants of solid organs such as kidneys, there have been no reports of cancer transmission by blood transfusion. To check this, a group of researchers looked back in time at people who had received blood from donors who had developed cancer within 5 years of giving the blood. They found no increased cancer risk in those who got blood from those who were found to have cancer soon after donating.
The ACS states some obvious precautions, that you cannot donate blood if you are being actively treated for cancer, or if your cancer has spread or recurred, or if you’ve had leukemia, lymphoma or Kaposi’s sarcoma as an adult. Otherwise, if you stay cancer-free (meaning, for most of us NED or No Evidence of Disease) for 1 to 5 years after treatment, you can donate blood. If your cancer treatment involved only surgery to remove a non-invasive tumor, then you need only wait until you’ve recovered fully from your surgery. Visit the links for more information.
The U.S. Department of Health and Human Services maintains a website about organ donation. It states that, “There are few absolute exclusions [for organ donation] (such as HIV infection, active cancer, systemic infection) and no strict upper or lower age limits.” According to the American Cancer Society site, the tragic story of that little girl is rare, but not unheard of, for the reasons described.
But even if you’ve had cancer, some of your tissue and organs may still be safely donated. Kidneys are often donated from living donors. For other donations, if you have active cancer at the time of your death, your internal organs will not be used, but tissue like skin, bone and the corneas from your eyes may still be safe. The ACS site has links to the United Network for Organ Sharing, which provides details about the process of donating and signing up if you need a donation.
Bone Marrow Donation
The eligibility requirements for bone marrow donation are, understandably, more restricted. The City of Hope website explains them thoroughly. In general, with few exceptions, you cannot donate bone marrow if you have a history of cancer. However, you can donate bone marrow if you’ve had only basal cell skin cancer or in situ cancers, like DCIS, for example, or one of those lovely in-situ cancerous colon polyps, like the one I had removed early this year [see Dodging Those Cancer Bullets]. Further information about bone marrow donation and transplant may be found at Cancer.Net. Hmm. Since I am evidently so far only a two-time member of the Non-Invasive Cancer Club, I could donate even bone marrow without feeling like I might do more harm than good.
Paying It Forward
I know a healthcare clinician, a wonderful, endearing and competent woman I’ve known now for about twenty years, whose husband needed a kidney transplant. After screening his family members and checking the donor registry with no success, she decided — despite the odds — to have her tissue evaluated as a possible match. And lo and behold, she was a good match! So, a few summers ago, she donated one of her kidneys to her husband. And today, they are both well and healthy. Pretty incredible. Brings tears to my eyes just thinking about how they must both have felt at their success. You never know, do you?
For those of us who’ve had cancer, if we regain some measure of health, we often want more than ever to help someone else stay alive. Many of us are haunted by feeling like we are forever tainted by cancer. Before I researched this post, I couldn’t imagine that any of us could still donate our blood, organs or tissue. It’s good to know that, with suitable caution, we still can.
Have you ever donated or received a donation of blood, organs or bone marrow? Do you know someone who has? How do you feel about it now?