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| Home > Health Issues and Concerns > Wellness Management > Second Malignancies |
| Second Malignancies |
Issue
Increased awareness about second malignancies: tie in with need for a healthy lifestyle.
Background
Secondary cancers, although rare, may be a result of the treatment you received. It may also be related to having a family predisposition for the development of certain cancers. It is important not to live your life with the fear of developing another cancer, but to focus on maintaining a healthy lifestyle.
Information
Current information shows that approximately 5% of survivors may develop a secondary cancer. This cancer can be related to treatment, such as radiation and certain chemotherapy agents belonging to the alkylating group, like Cytoxan, Ifosfamide, Melphalan, and Etoposide. It is important to keep in mind that these cancers are rare and may be related to other factors such as, genetic tendencies and lifestyle practices like smoking or eating a high fat diet.
One study looked at 3,711 children who were treated for acute lymphocytic leukemia. They studied these children for eleven years looking for second cancers. Less than one percent of all the children developed another type of cancer. Children receiving radiation therapy and/or alkylating drugs had a slightly higher incidence of a second cancer (1-2%). When compared to the overall cure rate for ALL (70%), this seems to be an acceptable risk.
It is important as children age that they develop an appreciation for maintaining a healthy lifestyle including yearly physical examinations and proper diet with high fiber fruits and vegetables, as well as moderate exercise.
Here are some risk factors to be aware of and some prevention methods you can take to help decrease those risks.
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| Skin | Sun exposure, radiation therapy, chemotherapy | Sunscreen, avoid sunbathing, and tanning booths | Self exam, mole mapping and removal of suspicious moles. |
| Lung | Smoking, radiation to chest, coal dust, asbestos | Not smoking, avoid passive smoke exposure | CXR |
| Colorectal | Low fiber diet, colonic polyps, age>60, radiation to abdomen | High fiber diet (25-35 grams/day) | Stool for occult blood and rectal exam every year after 40. |
| Breast | Family history, radiation to chest, fibrocystic disease, never giving birth, having first child after 30, high fat diet, late menopause | Monthly breast self exam | Baseline mammogram at age 35, every 1-2 years until age 40 then yearly. If you have any risk factors; baseline mammogram at age 25 and yearly after age 40. |
| Prostate | Age greater than 50 | Rectal exam by a doctor every year after age 40, prostate specific antigen yearly. | |
| Uterus/Cervix | Sexual activity at a young age, early childbearing, multiple sex partners, history of a sexually transmitted disease | Pelvic exam by a doctor yearly, pap smear yearly or as often as your doctor recommends | |
| Testes | Undescended testicles, radiation to testicles | Monthly testicular self-exam | Testical exam by a doctor every year |
Also, become familiar with the "Seven Warning Signs Of Adult Cancers" which include:
Notes
Discuss with your treatment facility if you received any therapy that may put you at risk for development of a second cancer. Examine your present lifestyle and ask yourself is there something I could change to make my life healthier.
Resources
American Cancer Society "Seven Warning Signs of Cancer"
Bhatia S., Sather, M., Trigg P. Second Malignant Neoplasms Following Childhood Acute Lymphocytic Leukemia: Follow-up of Children's Cancer Group. Proceedings of ASCO Volume l7, l998
"Caring for Life" booklet
Prepared by: Jerelyn Moffet, RN, MS, CSNP; Peggy Possin, RN, BSN; Sharon Frierdich, RN, MS, CPNP; Paul Gaynon, MD
Nessim S, Ellis, J. Cancervive: The challenge of life after cancer. Houghton Mifflin Co. Boston, l991.