Being diagnosed with prostate cancer can be difficult to handle.
After treatment, being a prostate cancer survivor feels relieving and empowering.
But some patients may have an additional cause of worry if they get what we know as second cancer.
But is second cancer the same as metastasis? If your doctor finds cancer elsewhere, does it mean that prostate cancer has spread?
Some prostate cancer patients receive a second cancer diagnosis. They usually have many questions and worries about their condition.
What is second cancer, and how is it different from metastasis? If you have prostate cancer, what other types of cancer can you develop? Is there a way to lower your risk of second cancer?
After reading this article, you will be able to answer these concerns.
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What is second cancer?
Cancer cells are different from the original tissue. If cancer spreads, it will not have the same features as before. When cancer cells spread to other organs, they behave like seeds being planted in new ground.
New tumors arise, and they are called metastasis. Even if they are different from the original tissue, they share some traceable features. Thus, it is possible to say if they came from the primary tumor or not.
A second cancer is different because it is unrelated to any previous diagnosis. In other words, it is a different type of cancer.
It is usually found in another tissue, but you could also find it in the same organ. In most cases, second cancers develop in cancer survivors after treatment has been concluded. Thus, it is sometimes essential to differentiate second cancers from cancer recurrence.
Can prostate cancer increase the risk of other cancers?
Prostate cancer is similar to other types of cancer and has similar risk factors. Thus, if you have prostate cancer, you could have shared risk factors that activate second cancer.
Depending on the type of treatment you received for prostate cancer could also increase the risk. Thus, after resolving your cancer, it is vital to go through a careful follow-up. This way, urologists can trace the biochemical recurrence of prostate cancer or the growth of second cancer.
Radiation therapy is probably the leading cause of second cancers in these patients. However, it doesn’t mean that a high proportion of patients who go through radiotherapy get second cancer.
The risk is related to the dose of radiation that the patient receives. That’s why new therapy methods evaluate lower doses and combination treatment to achieve better results.
However, there is still not enough information about the efficacy and long-term effects of these newer methods. We can say that it is a matter of active research in the field of oncology.
On the other hand, patients who did not receive radiotherapy may also grow second cancer. This is due to overlapping risk factors that may trigger prostate cancer and other types of cancer at the same time. Prostate cancer was resolved, but the risk factors remain.
Still, the rate of second cancers is not excessively high. According to an article published in the New England Journal of Medicine, second cancer risk ranges between 0.1% to 4.2% depending on the type of cancer.
Higher risks are recorded in patients subject to external beam radiotherapy. Lower risks are recorded in patients who received brachytherapy. Thus, your particular risk depends on your baseline risk factors and the type of cancer therapy you received.
Does prostate cancer link with other types of cancer?
Studies show that prostate cancer is linked to a higher risk of other types of cancers. According to the American Cancer Society, they include:
- Thyroid cancer
- Skin melanoma
- Thyroid cancer
Additionally, there is a higher risk of acute myeloid leukemia and rectal cancer in patients treated with radiotherapy.
But depending on the source of the statistics, you could find slightly different data. For instance, according to the New England Journal of Medicine article cited above, there was no higher risk of hematologic malignancies. Thus, no increase in acute myeloid leukemia.
The incidence of bladder cancer was 0.1 to 3.8%. For rectal cancer, it was 0.3 to 1.2%. And the incidence of colon cancer was 0.3 to 4.2%.
As you can see, there’s no way to know if you’re getting second cancer or not. That’s why cancer screening and follow-ups are required to rule them out. Rest assured, the chance is very low, especially if you didn’t need radiotherapy to destroy cancer cells.
Can you lower your risk of getting second cancer?
If you’re a prostate cancer survivor, remember that your treatment was meant to eradicate prostate cancer, not other tumors. Thus, receiving treatment for prostate cancer does not mean that you will not suffer from another type.
It won’t provide any protection against second cancers in the future. Quite the opposite, because some cancer treatments may increase your risk. Talk to your doctor to know if this is likely to happen and what to do in your case to have a lower risk.
Doctors understand the risk of second cancers, and they act accordingly. They will guide you through preventative measures to keep you safe. They often include:
Your doctor will most likely recommend follow-up or surveillance. They are visits to the urologist or another healthcare professional after you’re done with prostate cancer therapy.
Even if you’re on hormonal treatment and other forms of extended treatment, you should schedule appointments with your doctor. In this appointment, your doctor will evaluate your general health, the effects of cancer treatment, and other aspects of your wellbeing. Second cancers are also ruled out in these visits.
Survivorship care plan
You will be given a survivorship care plan. It has a description of what needs to be done after cancer treatment. Talk to your doctor if you have any doubts about how to apply it.
Also, if you have a new symptom or concern, report them to your healthcare team. Even if you don’t think it is related to prostate cancer, do not hesitate to ask.
In some cases, doctors will recommend specific modifications to reduce your risk. They will also start screening guidelines depending on your levels of risk and the presence of cancer syndromes in your family. This screening plan is usually similar to the one described for healthy patients.
Healthy lifestyle and habits
The recommendations to reduce the risk of second cancer are easy to guess. They are similar to the lifestyle and habits healthy patients should follow to prevent cancer.
They include quitting tobacco and avoiding heavy alcohol consumption. Not consuming alcohol is recommended, or at least reducing the number of drinks by two drinks per day for men and one for women.
It is also recommended to stay at a healthy weight and get active with exercise as much as possible. Avoid physical inactivity.
A healthy eating pattern is also recommended. Avoid sugary drinks and highly processed foods. Limit red meat and try to eat plenty of fruits, vegetables, and whole grains. Doing so may reduce the risk of second cancer and other health issues.
Altogether, these recommendations are helpful to keep you healthy in many ways. One of them is protecting your cells against new tumors.
However, it is also essential to understand the risk factors of cancer. Some of them are modifiable. Others cannot be changed.
If you have non-modifiable risk factors, there is little to do about it, and you need to keep watch and try to catch new tumors as early as possible.
Cancer risk factors
As noted above, it is useful to identify modifiable and nonmodifiable risk factors. The former can be changed through diet, lifestyle, and environmental recommendations. The latter cannot be changed. But you need to be aware of them to guide screening and preventative strategies.
Non-modifiable risk factors
- Family history: This is essential to guide how often to screen for cancer and where to look for it. The heritability of cancer syndromes can be ruled out if you’re in doubt. For example, you can recognize families with Lynch syndrome because they have a high incidence of colon cancer and endometrial cancer.
- Gene mutations: When oncogenes are damaged, they trigger different types of cancer. These gene mutations may or may not run in your family. Genetic testing may hold the answer.
- Personal history: In this case, being a prostate cancer survivor is a non-modifiable risk factor. Your risk is slightly increased for the types of cancer listed above.
- Age: In most cases, older age increases the risk of different types of cancer. Others are more common in younger patients. Second cancers after prostate cancer are usually found in seniors.
- Ethnicity: Some cancers are more common in members of a given race or ethnic group. For instance, Ashkenazi Jews have an increased risk of colon and rectum cancer. If they are also prostate cancer survivors, these risk factors overlap.
- Other diseases: Certain medical conditions may increase your risk of cancer. For example, iron storage disease in the liver increases the risk of liver cancer. A weakened immune system and HIV make you vulnerable to uncontrolled tumor growth, especially in the skin. Diabetes mellitus and pancreatitis increase the risk of pancreatic cancer.
Modifiable risk factors
- Smoking: Tobacco smoking is probably the best example of a modifiable risk factor. Secondhand smoke also counts if held for a long time. After quitting, patients reduce their relative risk of various cancers over the years, not only lung cancer.
- Environmental hazards: Workers in leather, chemical, dye, and textile industries may increase the risk of certain types of cancer. Limiting exposure and considering workplace modifications is sometimes valuable to prevent second cancer.
- Alcohol: The usual recommendation is limiting your alcohol consumption to two drinks a day in men and one in women. However, if you can quit drinking, the risk reduces further, especially in colon cancer.
- Obesity: Overweight and obesity are also risk factors to get rectum cancer, colon cancer, esophageal cancer, kidney cancer, liver cancer, and more. Thus, reaching a healthy weight is a fundamental measure to lower your risk.
- Ionizing radiation: Cancer risk increases if you’ve been subject to radiotherapy or another source of ionizing radiation. For instance, in a nuclear reactor accident or being an operator of medical devices that use radiation. It is located around the area that received ionizing radiation.
- Other diseases: Preventable health conditions such as acid reflux and Barret’s esophagus may increase cancer risk. In this case, it will be esophageal cancer. High blood pressure is known to increase the risk of kidney cancer. Finally, infections with the hepatitis B and hepatitis C virus is a common cause of liver cancer.
Colon cancer, bladder cancer, rectal cancer, and skin cancer incidence are higher in prostate cancer survivors. They are known as second cancers.
They are not related to prostate cancer in any way and should be differentiated from metastasis and recurrence.
Cancer prevention is fundamental to reducing second cancer cases. To prevent them, we can adopt a few lifestyle recommendations, such as quitting cigarette smoking.
Screening for a genetic mutation is recommended if cancer syndromes are suspected in your family. And follow-ups are fundamental to scan your body from cancer recurrence and second cancer incidence.