Can I Get Another Cancer After Having Non-Hodgkin Lymphoma?
Cancer survivors can be affected by a number of health problems, but often their greatest concern is facing cancer again. If a cancer comes back after treatment it is called a “recurrence.” But some cancer survivors may develop a new, unrelated cancer later. This is called a “second cancer.” No matter what type of cancer you have had, it is still possible to get another (new) cancer, even after surviving the first.
Unfortunately, being treated for cancer doesn’t mean you can’t get another cancer. People who have had cancer can still get the same types of cancers that other people get. In fact, certain types of cancer and cancer treatments can be linked to a higher risk of certain second cancers.
Survivors of non-Hodgkin lymphoma (NHL) are at increased risk of developing some second cancers, but less so than patients who were treated for Hodgkin disease. Overall, NHL survivors get new cancers about 15% more often than most people (the general population). The risk of a second cancer after NHL increases over time.
The risk of getting a second cancer is higher in those who were diagnosed and treated at younger ages (20 years old and younger), than those who were older (70 or older) when they were found to have NHL.
Survivors of NHL can get any type of second cancer, but they have an increased risk of:
- Melanoma skin cancer
- Lung cancer
- Kidney cancer
- Kaposi sarcoma
- Cancers of the head/neck area (includes the lip, tongue, floor of the mouth, throat, salivary glands, and voice box)
- Colon cancer
- Thyroid cancer
- Bone and soft tissue cancer
- Bladder cancer
- Leukemia and myelodysplastic syndrome
- Hodgkin disease
Radiation therapy to the chest increases the risk of breast cancer in women who were treated before age 30. Mesothelioma, a rare cancer of the outer lining of the lung, is also increased in those who were treated with radiation.
A higher risk of bladder cancer has only been seen in those who were treated with chemotherapy. The drug cyclophosphamide (Cytoxan®), especially if used in higher doses, is linked to bladder cancer.
Low-dose total body irradiation (TBI), which was once used to treat NHL, has been linked to an increased risk of leukemia. The risk of leukemia is also higher in those treated with chemotherapy, with the highest risk seen in those treated with both radiation and chemotherapy.
Patients who had autologous bone marrow transplants (meaning the patient's own bone marrow was used – not someone else’s) are also at increased risk for developing acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). This may be related to the chemo given before transplant.
A certain kind of lymphoma of the stomach called MALT lymphoma can often be treated with antibiotics instead of chemo or radiation because it can be caused by infection with a certain bacteria. Patients treated for MALT lymphoma of the stomach have an increased risk of other kinds of non-Hodgkin lymphoma as well as stomach cancer.
Follow-up after treatment
After completing treatment for NHL, you should still see your doctor regularly and may have tests to look for signs that the cancer has come back. Patients should let their doctors know if they have any new symptoms or problems, as they could be due to the lymphoma coming back or from a new disease or cancer.
Patients who have completed treatment should follow the American Cancer Society recommendations for the early detection of cancer, such as those for colorectal cancer and breast cancer.
Women who were treated with chest radiation prior to the age of 30 have an increased risk of breast cancer. The American Cancer Society recommends yearly breast MRIs in addition to mammograms and clinical breast exams beginning at age 30 for women who were treated with chest radiation while they were aged 10 to 30.
The Children’s Oncology Group has guidelines for the follow-up of patients treated for cancer as a child, teen, or young adult, including screening for second cancers. These can be found at www.survivorshipguidelines.org.
All NHL survivors should avoid tobacco smoke, as smoking increases the risk of many cancers, and may further increase the risk of lung cancer after NHL.
To help maintain good health, survivors should also:
- Achieve and maintain a healthy weight
- Adopt a physically active lifestyle
- Consume a healthy diet, with an emphasis on plant foods
- Limit consumption of alcohol to no more than 1 drink per day for women or 2 per day for men
These steps may also lower the risk of some cancers.
See Second Cancers in Adults for more information about causes of second cancers.
Last Medical Review: August 26, 2014 Last Revised: February 29, 2016