Second Cancers After Non-Hodgkin Lymphoma

Cancer survivors can be affected by a number of health problems, but often a major 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. 

People who have had non-Hodgkin lymphoma (NHL) can get any type of second cancer, but they have an increased risk of certain cancers, including:

• 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 chest radiation.

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. Let your doctors know if you have any new symptoms or problems, as they could be due to the lymphoma coming back or from a new disease or 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 these women.

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.

Lymphoma survivors should also follow the American Cancer Society recommendations for the early detection of cancer, such as those for colorectal, lung, and breast cancer. Most experts don’t recommend any other testing to look for second cancers unless you have symptoms.

Can I lower my risk of getting a second cancer?

There are steps you can take to lower your risk and stay as healthy as possible. For example, it’s important to stay away from tobacco products. Smoking increases the risk of many cancers, including some of the second cancers seen in people who have had lymphoma.

To help maintain good health, lymphoma survivors should also:

• Get to and stay at a healthy weight
• Keep physically active and limit the time you spend sitting or lying down
• Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods
• Not drink alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men

These steps may also lower the risk of some other health problems.

See Second Cancers in Adults for more information about causes of second cancers.