Secondary Malignancies

Chemotherapy and radiation therapy treatments may cause cancers later in life; these are referred to as secondary cancers. The most common type of secondary cancer is myelodysplastic syndrome, or acute myeloid leukemia. The antineoplastic agents most commonly associated with secondary malignancies are alkylating agents, etoposide, teniposide, and anthracyclines. While the risk for secondary cancers is extremely low, it must outweigh the risk of survival produced by treatment of the primary malignancy. Because secondary malignancies may not occur for several years after treatment, patients with relatively short-term survival owing to the primary malignancy should consider the more immediate benefits of chemotherapy. Radiation therapy rarely may cause solid tumors as secondary cancers decades after treatment. The most common example of radiation therapy-induced secondary malignancy is breast cancer, which rarely occurs after mantle field radiation therapy for Hodgkin's disease.

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