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Second Cancers

Although rare, the very treatment that saves a child’s life may cause a second cancer to develop later.

Everyone has some risk of developing cancer later in life. Several studies have shown that as childhood cancer survivors become older they have a slightly higher risk of developing a second cancer than the general public. Certain types of treatment for childhood cancer or a family history of cancer can increase the risk.

Treatments That Increase the Risk of Second Cancers

Certain chemotherapy drugs

Some survivors who were treated with chemotherapy may develop acute myeloid leukemia (AML). AML most commonly appears during the first 10 years after the completion of cancer treatment. The risk of developing a secondary leukemia is increased for people who were treated with:

Radiation Therapy

Radiation therapy, especially at a young age and at high dose, increases the risk of developing a cancer of soft tissues or bone cancer later in life. The most common sites include the skin, breast, central nervous system, thyroid gland, and bones.

These second cancers most commonly appear more than 10 years after treatment for the original cancer.

Other Risk Factors

  • Family history of cancer.
  • Hereditary cancer-predisposing gene changes. They are relatively rare. A study by the St. Jude-Washington University Pediatric Cancer Genome Project found that only 8.5% of childhood cancers are hereditary. Providers will suspect an inherited cancer syndrome if there is a family history of cancer repeatedly occurring in children and young adults. Another clue is cancer developing in both sides of paired organs – kidneys, eyes, or lungs.
  • Increasing age. The chances of developing cancer grow as people get older.

What Survivors Can Do


Reviewed: June 2018