People with tattoos may end up with blood cancers – Experts

Oncologists and Haematologists have cautioned Nigerians against the new trend of getting tattoos, warning that the art, which is a type of body modification has been linked to an increased risk of blood cancers, particularly lymphoma – cancer of the blood.

The experts, who spoke exclusively with PUNCH Healthwise explained that certain chemicals in tattoo inks, including polyaromatic hydrocarbons known for their carcinogenic properties, may contribute to developing these blood cancers.

They warn that these carcinogenic chemicals can trigger an immune reaction in the body, leading to the development of blood cancers.

Recall that the 2024 Ojude Oba Day celebration gained significant social media attention, particularly with a cancer survivor identified as Farooq Oreagba, stole the show, capturing hearts with his charismatic presence.

The highlight of the festival was when Oreagba, adorned in full aso-oke agbada regalia, emerged on his horse, complemented by a striking tattoo on his arm.

Photos and videos of Oreagba quickly circulated online, with many Nigerians expressing admiration for his tattoo and expressing interest in getting similar ones themselves.

However, experts in oncology and haematology quickly advised individuals with plans to get tattoos to be aware of the potential risks.

The physicians said that the process of tattooing involves injecting ink under the skin, where it can migrate into the lymphatic system and reach lymph nodes.

They explained that the presence of carcinogenic substances in these inks can lead to genetic damage and cellular changes that contribute to the development of lymphoma.

A Consultant clinical oncologist, Dr Charles Okwonna said the location and type of tattoo ink used are significant factors influencing the risk of developing blood cancers.

The cancer expert, who works at St. Luke’s Cancer Centre, United Kingdom, explained that the risk of developing blood cancers from tattoos is higher for people who have them placed near lymph nodes, such as the neck, armpits, and groin.

He said these were more likely to cause immune reactions due to higher chemical absorption in those areas.

He noted that the quality of ink and the tattooing process can increase the risk of developing blood cancers.

According to him, the quality of tattoo ink and the skill of the tattoo artist play crucial roles, adding that cheaper inks with more impurities may increase the risks.

Okwonna added, “Tattoo increases the risk of any of these blood cancers but it is more linked with lymphomas. This has been established recently.

 “During the process of drawing tattoos, the ink that is used contains a carcinogenic or has been shown to contain a carcinogenic chemical, which we call the polyaromatic hydrocarbons, and these chemicals have been implicated also in cancers of other parts of the body, especially of the nasopharyngeal.

 “Recently it has been shown through multiple studies, especially in Europe, that some of those inks contain these chemicals. What happens is, in the process of drawing the tattoo, these chemicals elicit some kind of complex reaction in the body, which we call an immunologic reaction.

 “So, when the chemicals get injected into you either locally or sometimes, it gets absorbed through the little lymphatic channels around the skin area where you’re having it, it gets absorbed. Systemically, your body sees this as a foreign body trying to invade it and then elicits an immune reaction.

 “The body elicits an immune reaction that tries to fight those chemicals. In the process of eliciting this immune reaction, over time, that immunity kind of gets exaggerated. When that happens, that’s when it starts to transform from being a normal immunologic reaction, to dysplasia (the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer), and then transform to a malignant immune reaction.”

He added, “What this means is that when you get an infection or when your body sees something coming to it like a foreign body, the body releases some cells, and these cells are immunologic. They include white blood cells, mast cells, and all that. So these cells’s basic work is to try to release some chemical substances that will fight those foreign things and prevent them from causing harm to the body.”

When asked about people more susceptible to getting cancer through tattoos, the oncologist explained that individual susceptibility to these immune reactions varies.

Okwonna said factors such as overall immune strength and skin type, where melanin may provide some protection, contribute to different responses among people.

 “I will not be able to tell you the particular types of ink, but I know for sure that there are grades to this thing. And then, the more polished it is, the less likely it is to have impurities and heavy metals that will cause you this kind of immune reaction.

 “Also, the process of tattooing itself is also an issue, and the site of the tattooing.

“So, having a tattoo somewhere distant, maybe on your feet, anywhere below your knee or even below your elbows, for instance, it’s less likely to involve lymph nodes as opposed to having a tattoo just at your neck or very close to your armpit or, close to your groin.

 “So, the chances are that drawing a tattoo in these areas where you have a very high presence of lymph nodes, will likely get those ink, and those chemicals that are in those inks absorbed very easily into the lymph nodes around that area. So the more the concentration of these in that area, the higher the chance of eliciting the immune reaction. So that’s why I talk about the sites, and then the process itself; the less sharp the tattoo blade itself is or the needle, the more the potential to elicit an immune reaction,” he noted.

The physician, however, stressed the importance of stricter regulations within the tattoo industry, pointing out that many tattoo artists prioritise profits over safety.

He called on the government and the relevant agencies to enforce standards that ensure safe ink compositions, professional practices, and post-tattoo health assessments.

Okwonna said, “The government should set minimum standards for the inks and instruments used in tattoos.

“Additionally, health checks should be mandatory after the tattooing process to detect any potential health problems early.”

On his part, a Consultant Haematologist, C Lab Nigeria, Dr Olaniyi Owoeye confirmed that tattoo inks contain chemicals that can cause genetic damage and lead to blood cancers.

Owoeye, who is also a lecturer at Olabisi Onabanjo University, Ago-Iwoye, Ogun State, explained that the ink gets into the blood and ends up in the lymph nodes, where it can cause genetic damage over time.

The haematologist stressed that this can lead to the development of lymphoma, a type of blood cancer.

The physician argued that the risk of cancer appears to be linked directly to the ink used, regardless of tattoo size or placement on the body.

While acknowledging that not everyone who gets a tattoo will develop cancer, the expert emphasised that certain individuals may be more susceptible.

He explained that multiple factors, including genetic variations and lifestyle behaviours like smoking, contribute to individual cancer susceptibility, making it challenging to predict who might develop cancer after getting a tattoo.

He further said, “One thing I would also like to point out is that the ink may not just be the single most important factor. There are also so many other factors like the lifestyle of the person doing tattoos, does the person smokes, and so many of those risk behaviours predisposed to cancers. So, it’s like a conglomeration of factors.

“There are a whole lot of factors that determine someone’s predisposition to cancers. And of course, I am sure a lot of people will agree with me that several people have tattoos, and they don’t end up having cancers.

“Some people even get exposed to some of these carcinogens, and they don’t eventually end up even having cancer. That shows you that there are a whole lot of factors that determine susceptibility to cancer. There are a lot of genetic variations from people to people that can affect that. And as I said earlier on, it’s like a conglomeration of factors.”

He added, “Formation of cancers is not usually something that only a single factor causes. Usually, it’s almost like you have a whole lot of factors coming together to cause genetic damage because naturally, the body resists such kind of damage. Substantial mechanisms in the human DNA protect the DNA itself from such kind of damage.

 “So, it’s only when these protective mechanisms get overwhelmed or they get affected themselves, that’s when cancer happens.

 “In some cancers, there are some theories that a single hit is not usually enough to cause a cancer. You need to have like, multiple hits to the gene to have that happening. So that explains why there are inter-individual variations.”

Owoeye also emphasised the importance of awareness and regulation in the tattoo industry.

He suggested that regulatory bodies should enforce standards ensuring the safety of tattoo inks and procedures.

This approach, he argued, can help mitigate risks associated with carcinogenic ink ingredients and ensure that consumers are informed about the potential health implications of their tattoo choices.

The physician pointed out that while tattoos are popular and considered trendy, especially among younger populations, the awareness of associated health risks remains crucial.

He recommended that individuals considering tattoos should inquire about the chemical constituents of the inks used and opt for safer alternatives to minimise potential health hazards.

Meanwhile, a study recently published in the journal eClinicalMedicine, found that having a tattoo was associated with 21 per cent higher odds of a lymphoma diagnosis.

The study suggested that tattoos may be a risk factor for malignant lymphoma that is actionable from a public health perspective.

The researchers stated that the concern lies with potentially carcinogenic chemicals in some tattoo inks. When injected, the body perceives them as foreign, triggering a low-grade inflammation that might contribute to cancer development.

The study included 11,905 people — 2,938 of whom had lymphoma and were between ages 20 and 60.

They were then given a questionnaire about lifestyle factors to see if they were tattooed or not.

1,398 participants answered the questionnaire, while the number of people in the control group was 4,193.

In the group with lymphoma, 21 per cent were tattooed (289 individuals), while 18 per cent were tattooed in the control group without a lymphoma diagnosis (735 individuals).

The study found no connection between tattoo size and cancer risk.