Having cancer in childhood increases the risk for a second malignancy later in life. True or false?

• A. True
• B. False
• C. Not sure
• D. Not applicable

Answer: (B)

Having cancer in childhood increases the risk for a second malignancy later in life. This happens because the treatments used to cure the first cancer—such as radiation therapy and certain chemotherapies—can damage normal cells and set up a second cancer years later. The risk grows over time as survivors live longer, and is influenced by the specific treatments given and the areas treated. For example, chest or mantle radiation raises the risk of breast cancer in women; neck or cranial radiation raises the risk of thyroid cancers or meningiomas; alkylating agents can increase the risk of leukemia; and radiated fields can lead to secondary sarcomas. Therefore, lifelong follow-up and appropriate surveillance are important for pediatric cancer survivors.