Second Cancers Caused by Cancer Treatment

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Non-Hodgkin lymphoma

Prostate cancer

Men whose prostates have been removed or destroyed with radiation can no longer get a new case of prostate cancer, but they can get recurrence of the original prostate cancer (the cancer can come back after treatment).

Men who are treated with radiation therapy have a higher risk of bladder cancer later on than men who had surgery to remove their prostates. They may also have a higher risk for colon and rectal cancer. This increased risk is mainly seen in men who were treated with external beam radiation therapy (EBRT). Men who had seed implants (brachytherapy) without EBRT may have a slightly increased risk of these cancers, but it is lower than what is seen with EBRT. Overall, the risk seen with radiation therapy is not high, but it can continue for more than 10 years after treatment.

The risk is likely related to the dose of radiation, as it is with other cancers. Men who get seed implants typically get less radiation to nearby organs than those who get EBRT, either by itself or along with seeds.

Newer methods of giving EBRT, such as intensity modulated and conformal beam radiation therapy, may have different effects on the risks of a second cancer. Because these methods are newer, the long-term effects have not been studied as well.

Some studies looking at the long term effects of prostate cancer treatment have found an increased risk of melanoma (a type of skin cancer) after radiation therapy, but this higher risk was seen after prostatectomy (surgery to remove the prostate) as well.

At one point, high doses of the female hormone estrogen were used to treat advanced prostate cancer. This was linked to breast cancer in some men. Estrogen is no longer a standard treatment for prostate cancer.

Follow-up care

Survivors who are treated with radiation have an increased risk of certain second cancers, so they should get careful follow-up. There are no special recommendations for watching for second cancers after prostate treatment at this time, although men who have had radiation to treat prostate cancer should be careful to follow screening recommendations for colorectal cancer to improve the chance of early detection. Your doctor will also be watching closely for recurrence of the prostate cancer. You should also report problems passing urine, blood in your urine, rectal pain, or rectal bleeding to your doctor right away.

All patients should be encouraged to avoid tobacco smoke. Men who smoke may further increase their risk of bladder cancer after prostate radiation, since smoking is a known risk factor for bladder cancer.

Last Medical Review: 01/30/2012
Last Revised: 01/30/2012