Aetiology, genetics and prevention of secondary neoplasms in adult cancer survivors

Abstract

Second and higher-order malignancies now comprise about 18% of all incident cancers in the USA, superseding first primary cancers of the breast, lung, and prostate. The occurrence of second malignant neoplasms (SMN) is influenced by a myriad of factors, including the late effects of cancer therapy, shared aetiological factors with the primary cancer (such as tobacco use, excessive alcohol intake, and obesity), genetic predisposition, environmental determinants, host effects, and combinations of factors, including gene-environment interactions. The influence of these factors on SMN in survivors of adult-onset cancer is reviewed here. We also discuss how modifiable behavioural and lifestyle factors may contribute to SMN, and how these factors can be managed. Cancer survivorship provides an opportune time for oncologists and other health-care providers to counsel patients with regard to health promotion, not only to reduce SMN risk, but to minimize co-morbidities. In particular, the importance of smoking cessation, weight control, physical activity, and other factors consonant with adoption of a healthy lifestyle should be consistently emphasized to cancer survivors. Clinicians can also play a critical role by endorsing genetic counselling for selected patients and making referrals to dieticians, exercise trainers, and others to assist with lifestyle change interventions.

Treatment patterns, outcomes and long-term toxicity among patients with Hodgkin’s lymphoma in real world: results of a hospital based registry

“…Развитие 2 опухолей у 1 пациента может быть слу-чайным совпадением, объясняться генетической пред-расположенностью, иммунодефицитом или отражать канцерогенное влияние факторов окружения, которое приводит к развитию нескольких опухолей у 1 пациен-та [16][17][18][19]. Очевидно, что не все вторые опухоли выз-ваны лечением.…”

Female Pelvis: Genital Organs

“…The most frequent secondary cancer following chemotherapy is acute myeloid leukemia (AML). The risk to develop AML increases already 2 years following therapy with a peak risk incidence between 5 and 10 years following chemotherapy (Travis et al 2013 ). The incidence of solid bone or soft tissue tumors following chemotherapy is relatively rare compared to radiation-induced bone tumors.…”

“…Secondary malignant neoplasms (SMNs) comprise one of the most potentially life-threatening sequelae, representing about one in six of all cancers reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program (Travis et al 2013 ;Wood et al 2012 ).…”

Anticancer chemotherapy in teenagers and young adults: managing long term side effects

“…38 However, several drugs have well established associations with a range of solid tumours. 37 Alkylating agents, topoisomerase II inhibitors, and antimetabolites have been shown to induce therapy related acute myeloid leukaemia and myelodysplastic syndrome. 39 Currently the only guidelines that exist for screening of second malignant neoplasms are for women at risk of breast cancer having received thoracic radiotherapy.…”

“…36 Quantifying the risk of second malignant neoplasm from specific chemotherapy regimens is difficult because TYA cancer survivors may be at risk of second cancers due to genetic or environmental factors. 37 Moreover, many protocols include radiotherapy, which itself is carcinogenic. 38 However, several drugs have well established associations with a range of solid tumours.…”