What is a Second Cancer?

Approved by the Cancer.Net Editorial Board, 08/2018

A second cancer is a new cancer that happens in someone who has had cancer before. It is a completely new and a different type of cancer than the first one.

A second cancer is not the same as a cancer recurrence. A recurrence happens when the first cancer comes back. If you are a cancer survivor, you probably watch for recurrence. A recurrence is the same type you had before, even if it develops in a different area of the body.

Second cancers are not uncommon. About 1 in every 6 people diagnosed with cancer has had a different type of cancer in the past.

Risk factors for a second cancer

The risk of second cancers is higher for people with who have had certain types of first cancers. Doctors cannot be certain who will get a second cancer, but they do know some risk factors. These include:

Inherited genes. An inherited gene is passed from parent to child within a family. An inherited risk could include having one or several family members with cancer or a condition linked to cancer.

Cancer that remains after treatment. Some people may have very low levels of cancer cells left in their body even after treatment.

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.

Risk factors also include the same things that put you at risk for a first cancer, such as:

  • Smoking

  • Environmental toxins

  • Being overweight

  • Drinking too much alcohol

  • Eating an unhealthy diet

Do I need cancer screenings more often than other people?

You are probably having screenings to check for a recurrence of the first cancer. Your doctor can also tell you if you need to be screened for other cancers. You should get these on the schedule your doctor recommends. If you have a high risk of cancer, you might have screenings more often than other people. Tell your doctor as much as possible about your family history and past cancer treatment.

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, such as having a specific cancer treatment in the past. But you can do some things to reduce your general cancer risk, such as:

  • Exercising regularly and eating a healthy diet

  • Not smoking

  • Limiting alcohol use (ask your doctor for specific guidelines)

You can talk with a genetic counselor about getting tested for gene mutations that are linked to cancer. If tests show that you have the mutation, you might choose a treatment to lower your risk of future cancers.

Fear of a second or recurrent cancer

Fear of getting a second cancer is common. So is fear of the first cancer coming back. Talk with your health care team about your specific risks and what you can do to stay as healthy as possible. Also talk about which cancer screenings you need and how often.

Talking with your doctor, loved ones, or a counselor can help you cope with fears of a second cancer and life as a survivor. You can also join a support group in person or online. Spending time with others who also had cancer can be very helpful.

Coping with a second cancer

Finding and treating the cancer early are important, just as with a first cancer. Make sure your doctor knows as much about your first cancer, its treatment, and your general health.

If an earlier cancer treatment likely caused the second cancer, you might question or blame yourself. But it is important to remember that cancer treatments change over time. You and your doctor most likely chose the best options available for your earlier treatment.

What you know about cancer, hospitals, and health care can help you cope with a second cancer. But you might also have strong memories and emotions. Your previous experience with cancer can help you make decisions about a second cancer. For example, you might want treatment in the same hospital or cancer center. You might also want similar support as before. Or you might choose to do things differently.

Questions to ask the health care team

Consider asking your health care team the following questions:

  • Was my earlier cancer or treatment a cause of this cancer?

  • What are my treatment options?

  • I have had cancer twice. Could a genetic mutation be the cause?

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

  • Who can I talk with about my concerns?

  • Can this cancer be cured? What result do you expect from treatment?

Related Resources

When the Doctor Says “Cancer”

Understanding Cancer Risk

Genetic Testing for Cancer Risk

More Information

American Cancer Society: What Are Second Cancers?