Cancer is life changing for most patients because of the trauma associated with its diagnosis as well as the often grueling physical, psychological, and financial burdens imposed by its treatment. Even in the best of circumstances, when cancer is cured, survivors may be left with long-lasting adverse effects of treatment and an increased risk of developing other cancers in the future.
The disturbingly increased risk of second primary cancers first became apparent in survivors of childhood and young adult cancers, and was thought to be due to genetic cancer predisposition syndromes that can cause multiple malignant diseases at a young age as well as to the aggressive and carcinogenic treatments they often receive.1 For example, individuals with Lynch syndrome not only have an increased risk of colorectal cancer at a young age, but also an increased risk of cancer of the uterus, ovary, breast, bile ducts, small bowel, and renal pelvis. Likewise, young women treated with radiation therapy to the chest for lymphoma have an increased risk of breast cancer later in life.