Second Cancer

A second cancer is a new cancer that may develop months or years after you have treatment that cured the original primary cancer.

Unlike cancer that comes back (recurs) or spreads from the primary cancer, a second cancer is a new cancer that’s not related to the primary cancer. Sometimes, this new cancer occurs in the same area as the primary cancer. Other times, it appears in a different area of your body.

Healthcare providers may refer to second cancers as second primary cancer or new primary cancer.

New or second cancers aren’t common. But the number of cases is growing as more people live longer after finishing their primary cancer treatment. One recent study found that 1 out of 12 cancer survivors had a second cancer.

Other research showed that 6 out of 100 cancer survivors developed a second cancer five years after completing treatment for their primary cancer. That number more than doubled to 13 out of 100 people developing a second cancer 15 years after they finish their primary cancer treatment.

Second cancer types

Cancer research shows that certain types of primary cancer are more likely to be associated with a second cancer. Some examples of primary cancers that can lead to a second cancer are:

• Bladder cancer, which may lead to lung cancer
• Breast cancer, which may result in ovarian cancer
• Colorectal cancer, which may result in cancers that affect your kidney or small intestine
• Kidney cancer, which may lead to lung cancer or multiple myeloma
• Prostate cancer, which may result in bladder cancer and kidney cancer

Symptoms of second cancer

Like primary cancer, different symptoms can occur in second cancers.

Possible symptoms may include:

• Feeling tired all the time
• Persistent fever
• Abnormal or excessive bleeding, like bleeding when you cough, pee or poop
• Bruising for no obvious reason
• Changes in your skin, like a mole that gets larger
• A bump or lump that doesn’t go away
• Unexplained weight loss

Second cancer causes

Cancer researchers don’t know all the causes that may lead to a second cancer. Some potential causes are the primary cancer treatment, inherited genetic disorders and activities or exposure to carcinogens that can cause cancer.

Cancer treatments

Chemotherapy and radiation therapy to treat the primary cancer may cause a second cancer to develop. For example, chemotherapy for breast cancer can lead to leukemia or myelodysplastic syndrome. Radiation therapy for prostate cancer may cause the development of bladder or kidney cancer.

You may be concerned to learn that the treatment that you hope will cure your primary cancer may later cause another cancer. But it’s important to remember that your oncologist recommends the treatments that are proven to be most effective for the cancer that you have. It’s also important to remember that it’s unusual to develop a second cancer from primary cancer treatment.

Ask your oncologist to explain any potential long-term complications your treatment may cause. Including a second cancer after completing primary cancer treatment.

Inherited disorders

You may have an inherited disorder that increases your risk of developing primary and secondary cancer. Your risk is greater than someone who doesn’t have that inherited disorder. Some examples are:

• Hereditary breast cancer
• Hereditary nonpolyposis colorectal cancer (HNPCC)
• Li Fraumeni syndrome
• Neurofibromatosis

Lifestyle and exposure to carcinogens

Certain lifestyle behaviors can increase the chance you’ll develop a cancer that may lead to a second cancer. For example, having obesity, smoking and drinking alcohol increases the risk you’ll develop cancer. Another example is excessive exposure to ultraviolet (UV) rays (sunlight), which increases the risk that you’ll develop skin cancer.

How doctors diagnose a second cancer

A healthcare provider will ask you about your symptoms. They’ll ask about your previous primary cancer history, including the specific type of cancer you had and the treatment you received. They may do tests that detect cancer, including:

• Blood tests for cancer
• CT scans, MRI scans, PET scans, ultrasound tests and X-rays
• Biopsy to check for cancer cells in a specific area of your body

How is second cancer treated?

Your treatment will focus on the new type of cancer. For example, if you had bladder cancer that led to lung cancer, your treatment may include surgery to remove a cancerous tumor in your lung. You may have chemotherapy or radiation therapy if surgery can’t remove the tumor.

When should I seek care?

Symptoms like feeling exhausted no matter how much rest you get, a cough or a lump that doesn’t go away are reasons to talk to your oncologists or cancer care team member. You should also let them know about symptoms like pain, fever or weight loss that happen for no apparent reason.

Can you survive?

Yes, you can. But overcoming a second cancer may depend on factors like the type of cancer you have, if tests detect the new cancer before it grows or spreads, and your overall current health. As you plan for treatment, ask your oncologist to explain what you can expect.

Can I prevent this condition?

You can’t always prevent a second cancer, but you can lower your risk and catch it early with regular screenings. Here are some things you can do to reduce your risk:

• Avoid activities that increase your cancer risk. This includes smoking, drinking alcohol or spending time in the sun without protection.
• Make and attend all follow-up appointments. They’re an opportunity for your healthcare provider to check on your overall health. It’s also a time when you can ask questions or share any concerns.
• Ask your healthcare provider about cancer screenings. They may recommend frequent screening tests that may detect a second cancer long before you have symptoms.

Is there anything I can do to feel better?

Take care of your health by eating well. And staying active may ease some of the stress that can come with a new cancer diagnosis.

Ask your oncologist about cancer rehabilitation. This care focuses on activities like physical therapy to help you build strength for cancer treatment. Counseling can help you manage stress and other mental health issues that cancer and cancer treatment can cause.

Palliative care is another important consideration. This care is an extra layer of support as you go through cancer treatment. Palliative care specialists can recommend strategies that help you manage symptoms like pain or cancer treatment side effects. They can also recommend resources like cancer support groups to help you manage the emotional impact that a second cancer diagnosis can cause.