Key Points for This Section

Childhood cancer survivors have an increased risk of developing a second cancer later in life. Childhood cancer survivors with certain genetic syndromes have an increased risk of developing a second cancer.

Childhood cancer survivors have an increased risk of developing a second cancer later in life.

Certain factors related to treatment increase the risk of second cancers. These include the following:

• Radiation therapy may cause solid tumors and leukemia.
• Risk of second cancers after radiation therapy is increased if alkylating agents were also used and if the patient is female, was younger at the time of diagnosis, or had Hodgkin lymphoma or soft tissue cancer.
• Certain anticancer drugs, such as alkylating agents or platinum drugs, may cause leukemia and myelodysplastic syndrome.
• Survivors of childhood Hodgkin lymphoma have the highest risk of developing second cancers, especially breast or thyroid cancer. Young age at diagnosis and treatment for relapsed disease increase the risk.
• Bone marrow transplants increase the risk of tumors later in life.

Childhood cancer survivors with certain genetic syndromes have an increased risk of developing a second cancer.

Some childhood cancer survivors have an increased risk of developing a second cancer because they have certain genetic syndromes that also placed them at risk of developing the primary cancer. These include the following:

• Neurofibromatosis.
• Li-Fraumeni syndrome.
• Familial polyposis.
• The genetic form of retinoblastoma.

Frequent and careful follow-up exams are very important for these childhood cancer survivors.

Glossary Terms

A type of drug that is used in the treatment of cancer. It interferes with the cell's DNA and inhibits cancer cell growth.

A procedure to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (an individual's own marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).

Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

The process of identifying a disease, such as cancer, from its signs and symptoms.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

An inherited condition in which numerous polyps (growths that protrude from mucous membranes) form on the inside walls of the colon and rectum. It increases the risk of colorectal cancer. Also called familial adenomatous polyposis and FAP.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.

A cancer of the immune system that is marked by the presence of a type of cell called the Reed-Sternberg cell. The two major types of Hodgkin lymphoma are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Symptoms include the painless enlargement of lymph nodes, spleen, or other immune tissue. Other symptoms include fever, weight loss, fatigue, or night sweats. Also called Hodgkin disease.

Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.

A rare, inherited predisposition to multiple cancers, caused by an alteration in the p53 tumor suppressor gene.

A group of diseases in which the bone marrow does not make enough healthy blood cells. Also called preleukemia and smoldering leukemia.

A metal that is an important component of some anticancer drugs, such as cisplatin and carboplatin.

The original tumor.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

The return of signs and symptoms of cancer after a period of improvement.

Cancer that forms in the tissues of the retina (the light-sensitive layers of nerve tissue at the back of the eye). Retinoblastoma usually occurs in children younger than 5 years. It may be hereditary or nonhereditary (sporadic).

Refers to a new primary cancer in a person with a history of cancer.

Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body.

An abnormal mass of tissue that usually does not contain cysts or liquid areas. Solid tumors may be benign (not cancer), or malignant (cancer). Different types of solid tumors are named for the type of cells that form them. Examples of solid tumors are sarcomas, carcinomas, and lymphomas. Leukemias (cancers of the blood) generally do not form solid tumors.

A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.

A gland located beneath the larynx (voice box) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism. Also called thyroid gland.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.