Life After Cancer: Understanding Second Cancer  

Having cancer once does not mean you won’t ever have cancer again. Anyone who has had cancer has a risk for developing a new kind of cancer someday. This is called a second cancer. Second cancer can occur any time after treatment for the first cancer. 

A second cancer can start in a new place. For example, if you had breast cancer, you may have a new lung cancer in the future. Or you may have cancer in the same place. You may have had colon cancer. Then you have a second type of colon cancer years later. 

Second cancers are not the same as cancer recurrence. A second cancer is a new cancer. Recurrent cancer is the same cancer coming back after treatment. 

What causes second cancer?

It’s hard to know exactly what causes cancer. There are many known risk factors that can raise the risk for cancer. The second cancer may be caused by whatever caused the first cancer. Or it may be caused by something else. Second cancers can also be caused by any of the below:

Radiation therapy for your first cancer

Radiation treatment kills cancer cells. But it can also damage nearby normal cells, which can lead to cancer. This means radiation to a certain part of the body can raise the risk for a new cancer growing in that same part of the body. It may cause tumors that don’t appear for many, many years after treatment. For example, radiation to the chest to treat breast cancer may lead to lung cancer in the future. Radiation to the bone marrow may lead to leukemia. Radiation for prostate cancer may lead to bladder or rectal cancer. In general, the more radiation you have had, the higher the risk for a second cancer in the treatment area.

Chemotherapy for your first cancer

Some kinds of chemotherapy medicines have been linked to new cancer. And some are linked to getting the blood cancer called leukemia later in life. Make sure to ask your healthcare team if your chemo can raise your risk for leukemia or any other types of cancer in the future. 

Other factors

There are many possible causes of cancer. The most important risk factor for most types of cancer is age. This means surviving cancer once gives you the opportunity to grow older and be at a higher cancer risk. Certain lifestyle factors are also linked to some types of cancer. These include:

• Using tobacco

• Drinking alcohol

• Eating a poor diet

• Being overweight

Gene changes that are passed down in families can lead to cancer, too. Other factors linked to cancer are:

• Infection with certain viruses, such as human papillomavirus (HPV) and HIV

• Pollution

• Sun exposure

• Certain kinds of jobs

What is my risk for a second cancer?

People who have had cancer are often at higher risk for other types of cancer. Your risk may be higher in the first year or so after treatment. It may then drop. Or it may be higher many years later. Risk varies depending on the type of cancer you had and what types of treatments you had. It also varies depending on your family’s history of cancer and your overall health and lifestyle.

Your healthcare providers can tell you more about your personal risk for certain kinds of second cancer. They can also tell you what you can do to decrease your risk and what you should watch for.

Can I lower my risk for second cancer?

There's no guarantee that you can prevent a second cancer. But you can take steps to lower your risk for one:

• Eat a healthy diet with plenty of fruits, vegetables, and whole grains.

• Get exercise every day.

• Get to or stay at a healthy weight.

• Don’t use tobacco.

• Limit alcohol to 1 drink a day if you are a woman, 2 if you are a man.

Checking for second cancer

Keep your appointments with your healthcare team. Your providers will ask you how you're feeling and what, if any, changes or symptoms you have. Get regular cancer screening tests as advised by your healthcare provider. Be sure to tell your healthcare team if you have new symptoms that don’t go away, such as:

• Pain

• Trouble breathing

• Lumps or swelling

• Weight loss

• Easy or unusual bleeding or bruising

• Fevers

• Blood in your urine or stool

• Abnormal vaginal bleeding or discharge

• Nausea, vomiting, or diarrhea

• A cough that doesn’t get better

• Tiredness that doesn’t get better with rest

• Skin changes

• Sores that don’t heal

Keep in mind that these symptoms may be, and are most likely, caused by other things. You may have an infection or other problems that can be easily treated.

Working with your healthcare team

Talk with your healthcare team about what kinds of second cancer you may be at risk for. They can help you understand what to watch for and what kinds of things may lower your risk. They can also make sure you get the recommended cancer screening tests.

The most important thing about checking for and coping with second cancer is working with your healthcare team. Your team can give you information and support. They can help you stay healthy.