Tim loves to stay active outdoors and uses sun protection while hiking in Park City, Utah (above left), and with his daughter, Amanda, in the Great Smoky Mountains in Tennessee (above, right)
As a young athlete often playing sports or swimming outside, Tim Davidson never thought much about the dangers of sunburn. He also never imagined he would have a health issue that would make those childhood sunburns come back to haunt him.
By Kelly McCoy, MD, and C. William Hanke, MD
As a computer programmer over four decades, Tim Davidson witnessed world-changing advances in technology, from the dawn of the digital age to the AI era. Today, at 62, he is enjoying retirement, thanks to advances in modern medicine that make him a survivor — through three kidney transplants and dozens of skin cancers.
It all started during his outdoorsy childhood in the Indianapolis area, where he still resides. As a self-described “sports type, from swimming to football,” he says, “I don’t think I ever thought of sun protection at all in those days. And no, I never got tan; I always got sunburned. I’d fry and peel!” That left his skin covered with freckles and brown spots (aka sun damage).
He married his high-school sweetheart, Beth, at age 18, and they loved outdoor activities together. But while they were having fun in the sun, damage from exposure to those dangerous ultraviolet (UV) rays continued to add up. And for Tim, that had the potential to be a big problem.
He was just 24 when his health began to unravel. “I started to have a lot of swelling in my ankles,” he explains. “I thought nothing of it at first, but it got worse. Then I started to wake up in the middle of the night having trouble breathing. That was scary.”
Both symptoms continued and eventually led to an emergency room visit. The doctors initially suspected pneumonia. Weeks later, still struggling to breathe and now with worsening swelling, the true diagnosis became clear: kidney failure caused by IgA nephropathy, a chronic disease that damages the kidneys.
At 25, Tim began dialysis, a grueling procedure that filters the blood to remove waste and extra fluid, then returns the clean blood back into the body. It takes three to five hours, often three times a week. He and his doctors thought that since Tim was young and athletic, the dialysis might allow his kidney to recover and function again. He was devastated when it didn’t. When his doctor told him he would need a kidney transplant, “I was really shocked,” he recalls. “Beth and I had two little kids then. I definitely had a ‘Why me?’ moment.”
First Transplant
Tim’s name was placed on a transplant list. The dialysis kept him alive but tethered to machines while he waited for a match. A year later, in October 1987, his life changed when he received his first kidney transplant.
“After you go for dialysis for a year,” he explains, “you’re so down, so weak and feel so bad. But pretty much right after the transplant, I felt really good! You wake up and think, Hmm, I think I feel better, just like that! When I was released from the hospital, I could just do everything I had been doing before.”
But Here’s the Downside
With the help of immunosuppressive drugs like tacrolimus (Prograf) and prednisone, his new kidney gave him nearly two decades of health. But while immunosuppressants are lifesaving, they also come with serious trade-offs. By weakening the immune system to protect transplanted organs, these medications leave the body more vulnerable to infections and certain cancers — particularly skin cancer.
And that risk isn’t small: Recent studies in JAAD cited that organ transplant patients have a 65- to 250-fold higher risk of squamous cell carcinoma (SCC) and a 10-fold higher risk of basal cell carcinoma (BCC) than patients who are not immunocompromised. Studies have also shown that SCCs in transplant patients are more aggressive and more likely to spread, or metastasize.
Second Transplant
As time passed, Tim’s disease and rising blood pressure took their toll. In 2006, he learned the hard way that “after a while, a transplanted kidney may just stop working,” he says. He would need a second transplant. “My first kidney lasted 19 years, but then my creatinine numbers were just getting worse and worse, and that’s how they determined I needed another transplant.” He was lucky that another match could be found.
But in 2010 (23 years after his first transplant), the reality of the risk of skin cancer became clear. “That’s when I had my first skin cancer,” he recalls. Since then, he estimates he has had between 30 and 40 skin cancers removed, the majority of them SCCs, with some BCCs as well. (None have been melanoma.) Almost 75 percent of them have appeared on his head and neck, leaving a roadmap of thin scars that tell the story of countless procedures.
Third Transplant
That second kidney lasted nine years. Then, in 2015, Tim received a third kidney — this time, from his wife, Beth. “It was her decision,” he says. “I wouldn’t put any pressure on anybody to do that, especially Beth, who doesn’t want to sit around and do nothing; she loves to stay active, doing yardwork, going to football and basketball games. I didn’t want to slow her down.” Luckily, her surgery was minimally invasive with a fairly quick recovery. “It’s been 10 years now with this kidney,” he says with gratitude.
Treatment
“It’s definitely impacted me,” Tim says. “I have scars all over my face and neck from treatment.” While he saw other dermatologists initially, he has been seeing me (dermatologist and Mohs surgeon C. William Hanke, MD, co-author of this story) for the past decade for Mohs surgery. “I get along great with him,” Tim says. “We have a good relationship. They always tease me, like maybe I should be getting my mail at his office, since I’m there all the time. It seems like I always have a spot that needs to be looked at. So sometimes it’s every month, but the minimum, it’s every two months.”
Tim says having the Mohs procedure is “a big relief, knowing you got all the cancer before you leave. And he’s good at closing them up and making the scars look good, too. I know it has to be done, and I have to make the best of it.”
Tim’s face and forearms reveal rough texture, discolored skin and scars from 30 to 40 cancerous growths caused by long-term immune suppression. Medical photos courtesy of C. William Hanke, MD
Proactive with Prevention
Tim says he now avoids the sun whenever possible, wears a hat outdoors and applies at least SPF 50 sunscreen religiously. “I really just don’t want to be in the sun a whole bunch. Yeah, when I was younger, I was out all the time, no shirt on, but now I just keep covered up. And if I do get in the pool, I make sure I am wearing sun-protective long-sleeved clothing, a hat and sunscreen. And I’m not out there very long.”
Through it all, Tim has maintained his perspective. He and his wife raised three children, and “that has been the biggest blessing,” he says. Now they have eight grandchildren, at last count. “We get together on holidays,” he says, “and we usually take a family vacation together. I’m a lot more protective of the grandkids, to make sure they’re protected from the sun starting young.”
Tim’s story is a powerful reminder: for solid organ transplant recipients, vigilance against skin cancer is not optional — it’s essential. With lifelong immunosuppression comes increased vulnerability, but with early detection, consistent dermatologic care and a commitment to sun safety, transplant patients can keep going for a long time.
His advice for the tens of thousands of organ transplant patients like him? “See a dermatologist and just get checked out. Then see them on a regular basis, because you never know. The earlier, the better — it could save your life.”
Can Transplant Patients with Advanced Skin Cancers Receive Immunotherapy Treatment?
Medical oncologist Ann W. Silk, MD, assistant professor of medicine at Harvard Medical School, who published a 2024 study in the Journal Cancers titled “Cutaneous Squamous Cell Carcinoma in Patients with Solid-Organ-Transplant-Associated Immunosuppression,” says:
“Patients who have undergone solid-organ transplant are at higher risk of developing aggressive SCCs, which are associated with increased morbidity and mortality. Treatment with immunotherapy remains challenging due to safety and efficacy concerns, but there is emerging evidence that immunotherapy can be safe and effective if it is delivered with an experienced multidisciplinary team. Ongoing research continues.”
What Is Chronic Kidney Disease?
Nick Mangold
Elsa / Getty Images
In October 2025, millions of people learned about chronic kidney disease (CKD) when beloved former New York Jets player Nick Mangold (below) died of complications from the disease. Fans all over the country were shocked by the news stories and learned some of the facts about CKD:
- CKD is the long-term loss of kidney function leading to buildup of toxins in the body, according to the National Kidney Foundation. The disease often progresses slowly, and patients may not feel symptoms in its initial stages. This leads to later diagnoses.
- More than 1 in 10 U.S. adults, or about 37 million Americans, are
estimated to have CKD, according to a 2026 report by the Centers
for Disease Control. - Approximately 90,000 people in the U.S. are waiting for a kidney at any given time, according to the United Network for Organ Sharing (UNOS).
- About 11 people die every day waiting for a kidney, according to UNOS.
About The Authors
Kelly McCoy, MD, is a Mohs micrographic surgery and dermatologic oncology fellow at Ascension St. Vincent Hospital in Indianapolis.
C. William Hanke, MD, is the program director for the Micrographic Surgery and Dermatologic Oncology Fellowship Training Program at Ascension St. Vincent Hospital in Indianapolis. He also serves as a senior vice president of The Skin Cancer Foundation and is a former president of the American Academy of Dermatology.
