Skip to main content

Care of Transgender Patients: Oncological Concerns

  • Chapter
  • First Online:
Urological Care for the Transgender Patient

Abstract

The oncologic care of the transgender patient is an area of increasing interest as this patient cohort continues to grow. Caring for these patients may be challenging due to limited literature on this topic and a lack of standard screening recommendations. It is critical that providers have a thorough knowledge of the transgender patients’ surgical and medical history related to the affirmation process to guide their care. The following chapter describes the known oncologic concerns in these patients based on the limited available literature.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kiran T, Davie S, Singh D, Hranilovic S, Pinto AD, Abramovich A, et al. Cancer screening rates among transgender adults: Cross-sectional analysis of primary care data. Can Fam Physician. 2019;65(1):e30–e7.

    PubMed  PubMed Central  Google Scholar 

  2. Joint R, Chen ZE, Cameron S. Breast and reproductive cancers in the transgender population: a systematic review. BJOG. 2018;125(12):1505–12.

    Article  CAS  Google Scholar 

  3. Deutsch M. Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people. 2nd ed: University of California San Francisco, Center of Excellence for Transgender Health, Department of Family and Community Medicine; 2016.

    Google Scholar 

  4. Ceres M, Quinn GP, Loscalzo M, Rice D. Cancer screening considerations and cancer screening uptake for lesbian, gay, bisexual, and transgender persons. Semin Oncol Nurs. 2018;34(1):37–51.

    Article  Google Scholar 

  5. Feldman J, Deutsch M. Primary care of transgender individuals UpToDate2019 [updated October 2018; cited 2018].

    Google Scholar 

  6. James SE, Herman JL, Rankin S, Keisling M, Mottet L, Anafi M. The report of the 2015 U.S. transgender survey. National Center for Transgender Equality: Washinton, DC; 2016.

    Google Scholar 

  7. Grant JM, Mottet LA, Tanis J, Herman JL, Harrison J, Keisling M. National transgender discrimination survey report on health and health care. Washington, DC: National Center for Transgender Equality and the National Gay and Lesbian Task Force; 2010.

    Google Scholar 

  8. Gatos KC. A literature review of cervical cancer screening in transgender men. Nurs Womens Health. 2018;22(1):52–62.

    Article  Google Scholar 

  9. Unger CA. Care of the transgender patient: a survey of gynecologists' current knowledge and practice. J Womens Health (Larchmt). 2015;24(2):114–8.

    Article  Google Scholar 

  10. Rebbeck TR. Prostate cancer genetics: variation by race, ethnicity, and geography. Semin Radiat Oncol. 2017;27(1):3–10.

    Article  Google Scholar 

  11. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.

    Article  Google Scholar 

  12. Grady D, Gebretsadik T, Kerlikowske K, Ernster V, Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol. 1995;85(2):304–13.

    Article  CAS  Google Scholar 

  13. Smith RA, Andrews KS, Brooks D, Fedewa SA, Manassaram-Baptiste D, Saslow D, et al. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2019;69(3):184–210.

    Article  Google Scholar 

  14. Kent MA, Winoker JS, Grotas AB. Effects of feminizing hormones on sperm production and malignant changes: microscopic examination of post orchiectomy specimens in transwomen. Urology. 2018;121:93–6.

    Article  Google Scholar 

  15. Bizic M, Kojovic V, Duisin D, Stanojevic D, Vujovic S, Milosevic A, et al. An overview of neovaginal reconstruction options in male to female transsexuals. Sci World J. 2014;2014:638919.

    Article  Google Scholar 

  16. Yamada K, Shida D, Kato T, Yoshida H, Yoshinaga S, Kanemitsu Y. Adenocarcinoma arising in sigmoid colon neovagina 53 years after construction. World J Surg Oncol. 2018;16(1):88.

    Article  Google Scholar 

  17. Webster T, Appelbaum H, Weinstein TA, Rosen N, Mitchell I, Levine JJ. Simultaneous development of ulcerative colitis in the colon and sigmoid neovagina. J Pediatr Surg. 2013;48(3):669–72.

    Article  Google Scholar 

  18. McEvenue G, Xu FZ, Cai R, McLean H. Female-to-male gender affirming top surgery: a single surgeon’s 15-year retrospective review and treatment algorithm. Aesthet Surg J. 2017;38(1):49–57.

    Article  Google Scholar 

  19. Deutsch MB, Radix A, Wesp L. Breast Cancer screening, management, and a review of case study literature in transgender populations. Semin Reprod Med. 2017;35(5):434–41.

    Article  Google Scholar 

  20. Gooren L, Morgentaler A. Prostate cancer incidence in orchidectomised male-to-female transsexual persons treated with oestrogens. Andrologia. 2014;46(10):1156–60.

    Article  CAS  Google Scholar 

  21. Markland C. Transexual surgery. Obstet Gynecol Annu. 1975;4:309–30.

    CAS  PubMed  Google Scholar 

  22. Thurston AV. Carcinoma of the prostate in a transsexual. Br J Urol. 1994;73(2):217.

    Article  CAS  Google Scholar 

  23. van Haarst EP, Newling DW, Gooren LJ, Asscheman H, Prenger DM. Metastatic prostatic carcinoma in a male-to-female transsexual. Br J Urol. 1998;81(5):776.

    Article  Google Scholar 

  24. Miksad RA, Bubley G, Church P, Sanda M, Rofsky N, Kaplan I, et al. Prostate cancer in a transgender woman 41 years after initiation of feminization. JAMA. 2006;296(19):2316–7.

    Article  CAS  Google Scholar 

  25. Dorff TB, Shazer RL, Nepomuceno EM, Tucker SJ. Successful treatment of metastatic androgen-independent prostate carcinoma in a transsexual patient. Clin Genitourin Cancer. 2007;5(5):344–6.

    Article  Google Scholar 

  26. Turo R, Jallad S, Prescott S, Cross WR. Metastatic prostate cancer in transsexual diagnosed after three decades of estrogen therapy. Can Urol Assoc J. 2013;7(7–8):E544–6.

    Article  Google Scholar 

  27. Ellent E, Matrana MR. Metastatic prostate cancer 35 years after sex reassignment surgery. Clin Genitourin Cancer. 2016;14(2):e207–9.

    Article  Google Scholar 

  28. Sharif A, Malhotra NR, Acosta AM, Kajdacsy-Balla AA, Bosland M, Guzman G, et al. The development of prostate adenocarcinoma in a transgender male to female patient: could estrogen therapy have played a role? Prostate. 2017;77(8):824–8.

    Article  CAS  Google Scholar 

  29. Deebel NA, Morin JP, Autorino R, Vince R, Grob B, Hampton LJ. Prostate Cancer in transgender women: incidence, etiopathogenesis, and management challenges. Urology. 2017;110:166–71.

    Article  Google Scholar 

  30. Morgentaler A, Rhoden EL. Prevalence of prostate cancer among hypogonadal men with prostate-specific antigen levels of 4.0 ng/mL or less. Urology. 2006;68(6):1263–7.

    Article  Google Scholar 

  31. Hoffman MA, DeWolf WC, Morgentaler A. Is low serum free testosterone a marker for high grade prostate cancer? J Urol. 2000;163(3):824–7.

    Article  CAS  Google Scholar 

  32. Wolf-Gould CS, Wolf-Gould CH. A transgender woman with testicular cancer: a new twist on an old problem. LGBT Health. 2016;3(1):90–5.

    Article  Google Scholar 

  33. Gooren LJ, van Trotsenburg MA, Giltay EJ, van Diest PJ. Breast cancer development in transsexual subjects receiving cross-sex hormone treatment. J Sex Med. 2013;10(12):3129–34.

    Article  Google Scholar 

  34. Brown GR, Jones KT. Incidence of breast cancer in a cohort of 5,135 transgender veterans. Breast Cancer Res Treat. 2015;149(1):191–8.

    Article  Google Scholar 

  35. Harder Y, Erni D, Banic A. Squamous cell carcinoma of the penile skin in a neovagina 20 years after male-to-female reassignment. Br J Plast Surg. 2002;55(5):449–51.

    Article  CAS  Google Scholar 

  36. Fernandes HM, Manolitsas TP, Jobling TW. Carcinoma of the neovagina after male-to-female reassignment. J Low Genit Tract Dis. 2014;18(2):E43–5.

    Article  Google Scholar 

  37. Lawrence A. Vaginal neoplasia in a male-to-female transsexual: case report, review of the literature, and recommendations for cytological screening. Int J Transgender. 2001;5(1).

    Google Scholar 

  38. Grosse A, Grosse C, Lenggenhager D, Bode B, Camenisch U, Bode P. Cytology of the neovagina in transgender women and individuals with congenital or acquired absence of a natural vagina. Cytopathology. 2017;28(3):184–91.

    Article  CAS  Google Scholar 

  39. Braun H, Nash R, Tangpricha V, Brockman J, Ward K, Goodman M. Cancer in transgender people: evidence and methodological considerations. Epidemiol Rev. 2017;39(1):93–107.

    Article  Google Scholar 

  40. American College of Obstetricians and Gynecologists. Committee opinion: health care for transgender individuals. Obstet Gynecol. 2011;118(6):1454–8.

    Article  Google Scholar 

  41. Peitzmeier SM, Khullar K, Reisner SL, Potter J. Pap test use is lower among female-to-male patients than non-transgender women. Am J Prev Med. 2014;47(6):808–12.

    Article  Google Scholar 

  42. Peitzmeier SM, Reisner SL, Harigopal P, Potter J. Female-to-male patients have high prevalence of unsatisfactory Paps compared to non-transgender females: implications for cervical cancer screening. J Gen Intern Med. 2014;29(5):778–84.

    Article  Google Scholar 

  43. Schenck TL, Holzbach T, Zantl N, Schuhmacher C, Vogel M, Seidl S, et al. Vaginal carcinoma in a female-to-male transsexual. J Sex Med. 2010;7(8):2899–902.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth Ferry .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Scott, K., Bratslavsky, G., Ferry, E. (2021). Care of Transgender Patients: Oncological Concerns. In: Nikolavsky, D., Blakely, S.A. (eds) Urological Care for the Transgender Patient. Springer, Cham. https://doi.org/10.1007/978-3-030-18533-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18533-6_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18532-9

  • Online ISBN: 978-3-030-18533-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics