Ronni Gordon is  a cancer survivor and long-time journalist who has written about her journey, about health and fitness, and about how she and others have prevailed in difficult situations. She brings to her writing a mix of personal experience with knowledge about the health-care system and how cancer patients can navigate it. A graduate of Vassar College with a master's degree in journalism from Boston University, she is a freelance writer who worked in daily newspapers for more than 30 years. She has been published in The New York Times, The Philadelphia Inquirer, Dana FarberCancer Institute magazine, and Cancer Today magazine. She lives in Western Massachusetts with her dog, Maddie, short for Madison (Avenue) in honor of her hometown, New York, and is mother of three grown children, Ben, Joe, and Katie

Ronni Gordon

Secondary Cancers: More Common Than You Think

Tuesday, 11 Jun 2013 09:52 AM

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A funny thing happened when I was hospitalized recently for pneumonia in both lungs. Not funny as in laugh-out-loud, but funny as in weird.
 
After doing a CT scan to determine the extent of the pneumonia, doctors saw what looked like a cyst on my kidney. One doctor said not to worry about it, but a second was concerned that it looked more irregular than a typical cyst. They next performed an MRI, after which they said it might be cancerous — just a small contained cancer sitting on the edge of my kidney.
 
"This is a miracle!" one of the doctors exclaimed. "You’re a miracle patient already," he said, referring to my four bone marrow transplants, my brush with death, and now my current good health. He said that full-fledged kidney cancer is difficult to detect until after it has spread, but what I have is totally treatable. I later saw a urologist who confirmed that it was good luck and no big deal; I’m scheduled for surgery in July, when he’ll slice it out and I will be cured.
 
This is not a secondary cancer in the technical sense of the word, when treatment for one cancer is known to lead to a specific other one. But it is a secondary cancer in the sense that people like me who have received a lot of chemotherapy and had their immune systems manipulated are at higher risk for other cancers. It already happened to me once, when the dentist found what looked like cancer on my tongue. A surgeon cut out a scoop of my tongue. The cells were actually pre-cancerous, but they had to come out anyway.
 
Second primary cancers have become an increasingly important concern in oncology during the last two decades, as they now comprise the sixth most common group of malignancies after skin, colorectal, lung, breast, and prostate cancers, according to the National Center for Biotechnology Information, a division of the U.S. National Library of Medicine.
 
Advances in radiation therapy and chemotherapy have increased the chances of survival for many people with cancer today. And with people living longer, it’s increasingly important to study the long-term effects of cancer treatment, according to the American Cancer Society. Still, according to the organization’s Website, "Cancer is a very common disease, and not all second cancers are due to cancer treatment." Certain inherited gene changes and exposure to carcinogenic substances are other causes of secondary cancers.
 
Even though it is hard to separate out the exact cause of anyone’s cancer, it’s important to be aware that one thing can lead to another.
 
Radiation therapy and the use of certain chemotherapy drugs can create a risk of getting acute myeloid leukemia (AML).
 
Breast cancer is known to create a risk for a new primary cancer in the opposite breast. Increased risk is also seen for cancers of the ovary, uterus, lung, colon, rectum, and connective tissue, as well as melanoma and leukemia. For a complete list of other secondary cancers and of the chemotherapy agents that can cause AML, see the American Cancer Society website.
 
So what’s a person to do? Get regularly scheduled check-ups, for starters, and, in terms of AML, be aware of increasing fatigue or widespread black-and-blue marks, two symptoms of the disease.
 
Sometimes you wish you could live in a glass bubble. But that wouldn’t be any fun. So you have to focus on controlling the things you can control and figure that if something does come up, you’ll deal with it when it happens.

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