Second cancers are on the rise, with nearly one in five new cancer cases in the US now involving someone who's had the disease before—but when doctors talk about second cancers, they mean a different tissue type or a different site, not a recurrence or spread of the original tumor. Judith Bernstein of suburban Philadelphia is an extreme example. She's had eight types over the last two decades, all treated successfully. "There was a while when I was getting one cancer diagnosis after another," including breast, lung, esophageal, and the latest: a rare tumor of her eyelids, she says. "At one point I thought I had cancer in my little finger." About 19% of cancers in the United States now are second-or-more cases, a recent study found; in the 1970s, it was only 9%. Over that period, the number of first cancers rose 70%, while the number of second cancers rose 300%.
This is partly a success story: More people are surviving cancer and living long enough to get it again, because the risk of cancer rises with age. Second cancers also can arise from the same gene mutations or risk factors, such as smoking, that spurred the first one. And some treatments that help people survive their first cancer can raise the risk of a new cancer forming later. Medically, second cancers pose special challenges: For example, radiation usually isn't given to the same area of the body more than once, and some drugs also have lifetime dose limits. Psychologically, a second cancer often is more traumatizing. "I think it's a lot tougher" for most people, says the director of the federal Office of Cancer Survivorship. Still, if you get a second cancer, "take a deep breath." Treatments improve daily; there are more resources, including social media, for support; and doctors are more used to treating cancer more than once. "No one's giving up on you," she says.