Second cancers are on the rise; 1 in 5 US cases is a repeat
Second cancers are on the rise. Nearly 1 in 5 new cases in the U.S. now involves someone who has had the disease before. When doctors talk about second cancers, they mean a different tissue type or a different site, not a recurrence or spread of the original tumor.
Judith Bernstein of suburban Philadelphia is an extreme example. She has had eight types over the last two decades, all treated successfully.
"There was a while when I was getting one cancer diagnosis after another," including breast, lung, esophageal, and the latest - a rare tumor of her eyelids, she said. "At one point I thought I had cancer in my little finger."
About 19 percent of cancers in the United States now are second-or-more cases, a recent study found. In the 1970s, it was only 9 percent. Over that period, the number of first cancers rose 70 percent while the number of second cancers rose 300 percent.
Strange as it may sound, this is partly a success story: More people are surviving cancer and living long enough to get it again, because the risk of cancer rises with age.
Second cancers also can arise from the same gene mutations or risk factors, such as smoking, that spurred the first one. And some of the very treatments that help people survive their first cancer, such as radiation, can raise the risk of a new cancer forming later in life, although treatments have greatly improved in recent years to minimize this problem.
Psychologically, a second cancer often is more traumatizing than the first.
"I think it's a lot tougher" for most people, said Julia Rowland, director of the federal Office of Cancer Survivorship. "The first time you're diagnosed, it's fear of the unknown. When you have your next diagnosis, it's fear of the known," and having to face treatment all over again.
Medically, second cancers pose special challenges. Treatment choices may be more limited. For example, radiation usually isn't given to the same area of the body more than once. Some drugs also have lifetime dose limits to avoid nerve or heart damage.