Blood Cancer as a Second Cancer

As doctors have more ways to successfully treat cancer, they’ve also found that some cancer survivors are more likely than the general population to develop what is known as a second cancer.

Not to be confused with a recurrence (when the original cancer makes a come-back), a second cancer is unrelated to the first cancer. And, blood cancers are one of the most common type of second cancers for certain types of cancer survivors.

Who is more susceptible to second cancers?

The good news is that developing any type of second cancer is a relatively rare occurrence. However, for a few patients, treatment for a primary cancer may increase the risk of developing blood cancer as a secondary cancer, usually many years after treatment ends.²

Doctors do not yet fully understand why this happens. However, they have found that people who are exposed to radiation and some chemotherapy treatments seem to be more vulnerable to developing secondary blood cancer.^1-4

Risk: Radiation exposure

Research conducted on survivors of the atomic bomb blasts in Japan, workers in jobs that exposed them to radiation, and patients treated with radiation has provided some of our best information on the long-term impact radiation exposure.¹

Doctors know that most types of leukemia, including acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome (MDS), a bone marrow cancer that can turn into acute leukemia, are linked to past radiation exposure.

The risk of developing leukemia depends on several factors, including:

• How much of the person’s bone marrow was exposed to radiation
• Quantity of radiation that penetrated the bone marrow
• How much radiation occurred with each dose and for how long, and how often the exposure took place

Risk: Chemotherapy treatment

Some types of chemotherapy are linked to ALL, MDS and AML. Sometimes, MDS occurs first, then turns into AML. Chemo is known to be a greater risk factor than radiation in causing leukemia. The types of chemo tied to leukemia are alkylating agents, platinum-based drugs, and topoisomerase II inhibitors.¹

Risk: Treatment for Hodgkin lymphoma

Researchers at the National Institutes of Health (NIH) have found that those treated for Hodgkin lymphoma (HL) face an increased chance of developing acute myeloid leukemia (AML) and non-Hodgkin lymphoma though that risk has dramatically decreased over the last 30 years thanks to improvements in treatment.^3-4

The NIH scientists studied more than 35,000, one-year Hodgkin lymphoma survivors in North America and Nordic countries between 1970 and 2001. They found that the risks of developing secondary AML were higher for patients who were over 35 at the time of their HL treatment if it occurred before 1984. The risk remained highest for the first 10 years after HL diagnosis and remained elevated after that.³

Lowering your risk of second cancers

Regular health screenings are the best way to spot and treat a second cancer early. A healthy lifestyle, such as eating a healthy diet, limiting alcohol consumption and UV exposure, regular exercise and not smoking, may help reduce the chances of developing a second cancer, including blood cancer.^1-2