What is a Second Cancer?

Aprobado por la Junta Editorial de Cancer.Net, 07/2021

When a person who has already had cancer develops a new cancer, it is called a second cancer or second primary cancer. It is a completely new and different type of cancer than the first one.

A second cancer is not the same as a cancer recurrence. A recurrence means that the first cancer has come back, in the same area of the body or in a different area.

A second cancer may be a late effect of your first cancer or its treatment, or it may be unrelated to your first cancer. Second cancers are becoming more common since more people are living longer after their first cancer diagnosis than ever before. About 1 in every 6 people diagnosed with cancer has had a different type of cancer in the past.

What are risk factors for a second cancer?

A risk factor is anything that increases a person's chance of developing cancer. Some people with several risk factors never develop a second cancer, while others with no known risk factors do. Knowing your risks and talking to your health care team may help you make lifestyle and health care choices.

Although risk factors often influence the development of a second cancer, your doctor cannot predict whether or not you will develop a second cancer. Your risk may be higher if you had a certain type of first cancer and if you have one of these risk factors:

Inherited genes. An inherited gene is passed from parent to child within a family. For example, having one or more family members with cancer or a condition linked to cancer would be a general risk factor for cancer.

Certain cancer treatments. Some types of chemotherapy and radiation therapy raise your risk of a second cancer. The risk is higher if you had treatment as a child, teen, or young adult.

Lifestyle habits. Risk factors include the same things that put people at risk for a first cancer, such as smoking and other tobacco use, being overweight, not getting regular physical activity, drinking too much alcohol, eating an unhealthy diet, and/or too much sun exposure.

Talk with your health care team about your specific risks and what you can do to stay as healthy as possible.

Do I need cancer screenings more often than other people?

The follow-up care you receive after you finish treatment for your first cancer should include screenings to check for a cancer recurrence. Your doctor can also tell you if you need to be screened for other types of cancers. Tell your doctor as much as possible about your past cancer treatment and family medical history. If you have a high risk of cancer, you might have screenings more often than other people. You should follow the cancer screening schedule your doctor recommends.

What are symptoms of a second cancer?

Symptoms of a second cancer may include:

  • Feeling tired

  • Having a sore that does not heal normally

  • Having a cough or hoarse voice that does not go away

  • Loss of appetite, difficulty digesting your food, or difficulty swallowing

  • A lump, discharge, bleeding, or thickening in a certain spot

  • Feeling like your bones ache

  • Headaches and vision changes

If you notice any of these changes, talk with your health care team as soon as possible.

Can second cancers be prevented?

Not always. You cannot control some risk factors, like a cancer treatment you received in the past or risk from inherited genes. But you can do some things to reduce your general cancer risk, such as:

And, you can talk with a genetic counselor about getting tested for certain gene mutations that are linked to cancer. If tests show that you have a mutation, you might choose a treatment to lower your risk of future cancers if available, such as chemoprevention.

Coping with a second cancer

Fear of getting a second cancer is common for cancer survivors. So is fear of the first cancer coming back. There are ways to help you regain a sense of control when facing this type of uncertainty. A good first step is talking with your doctor, loved ones, and/or a counselor as you cope with fears of a second cancer and with life as a survivor.

You can also join a support group in person or online. Spending time with others who have had similar first-hand experiences can be very helpful.

Staying up to date with your follow-up care appointments is also crucial. Finding and treating a new cancer early are important, just as with the first cancer. Make sure your doctor knows as much as possible about your first cancer, its treatment, and your general health.

If a second cancer is diagnosed, and an earlier cancer treatment likely caused it, you might question or blame yourself. But it is important to remember that a second cancer is never your fault. Your first cancer needed to be treated and cancer treatments are powerful.

If you are diagnosed with a second cancer, it can bring up a lot of memories and strong emotions. But you now know much more about cancer, treatment, hospitals, and health care, and all of this can help you cope with a second cancer. Your previous experience with cancer can help you decide how to approach your treatment and emotional support this time around.

Questions to ask the health care team

Consider asking your health care team the following questions as part of your general survivorship care:

  • Could my cancer or its treatment cause another type of cancer in the future? If so, which type(s) could I be at higher risk for?

  • What is my overall survivorship care plan? How will it include monitoring for a new cancer?

  • Are there other general cancer screening tests I should receive? How often?

  • What can I do at home to maintain or increase my health?

  • If I feel anxiety about the possibility of another type of cancer developing, who can help me cope with that?

After a diagnosis of a second cancer:

  • How likely is it that my earlier cancer or treatment caused this cancer?

  • Could a genetic mutation be the cause?

  • Would talking with a genetic counselor or having genetic testing help me?

  • Will my previous cancer treatment change the way I am treated for this new cancer?

  • Who can I talk with about my concerns and emotions about my second cancer experience?

  • What can I do to stay as healthy as possible during and after treatment?

Related Resources

Coping With a Secondary Cancer Diagnosis

Understanding Cancer Risk

Genetic Testing for Cancer Risk

Survivorship

Late Effects of Childhood Cancer

More Information

American Cancer Society: What Are Second Cancers?