You may wonder whether you are at increased risk of developing a second cancer. For most survivors, the answer is no. But the risk is not the same for everyone. Factors that determine risk include your genetic predisposition and whether or not you received radiation and/or certain chemotherapy drugs. Children with cancer predisposition syndromes are at higher risk of developing second cancers (Indelicato et al., 2021 and COG V 6.0 Section 7, Any Cancer Experience).

Your lifestyle and health behaviors can minimize or increase your risk, just as they can for people who never had cancer. For instance, if you had radiation to your chest, you have a small risk for developing throat and/or lung cancers. If you smoke, your chances of developing those cancers dramatically increase. If you don’t smoke, don’t drink alcohol, and eat a healthy diet, your risk decreases. See Chapter 5, Staying Healthy.

Much research is being done to maintain cure rates while lowering the toxicity of treatments to lessen the risk of second cancers. Pharmacogenetics (drug-genetic connection) is being used to identify the best cancer treatments while reducing the long-term effects including development of second cancers. Research is ongoing to identify those survivors most at risk so they can be followed appropriately. To find out your individual risk, talk to your healthcare provider during a follow-up visit. Before discussing your unique situation and risk, your provider will evaluate your original disease, the treatments you received, your age when treated, and your family history.