Key Points for This Section

Childhood cancer survivors have an increased risk of developing a second cancer later in life. Childhood cancer survivors with certain genetic syndromes have an increased risk of developing a second cancer.

Childhood cancer survivors have an increased risk of developing a second cancer later in life.

Certain factors related to treatment increase the risk of second cancers. These include the following:

• Radiation therapy may cause solid tumors and leukemia.
• Risk of second cancers after radiation therapy is increased if alkylating agents were also used and if the patient is female, was younger at the time of diagnosis, or had Hodgkin lymphoma or soft tissue cancer.
• Certain anticancer drugs, such as alkylating agents or platinum drugs may cause leukemia.
• Survivors of childhood Hodgkin lymphoma have the highest risk of developing second cancers, especially breast or thyroid cancer. Young age at diagnosis and treatment for relapsed disease increase the risk.
• Bone marrow transplants increase the risk of tumors later in life.

Childhood cancer survivors with certain genetic syndromes have an increased risk of developing a second cancer.

Some childhood cancer survivors have an increased risk of developing a second cancer because they have certain genetic syndromes that also placed them at risk of developing the primary cancer. These include the following:

• Neurofibromatosis.
• Li-Fraumeni syndrome.
• Familial polyposis.
• The genetic form of retinoblastoma.

Frequent and careful follow-up exams are very important for these childhood cancer survivors.

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