SURVIVORS OF CHILDHOOD CANCER may worry that treatment or genetic predisposition or the combination of the two will result in a second cancer. Second cancers are biologically different than a recurrence of the first cancer. The chance of developing a second cancer depends on a number of factors, including your original type of cancer, younger age at diagnosis, biological sex, types of therapy given, environmental exposures, genetic predisposition, and health decisions. Overall, for most survivors, the chance of getting a second cancer is very small.

This chapter begins with a discussion about what is currently known about the risks of getting a second cancer. Possible ways to prevent cancer and medical surveillance that may identify second cancers early are then discussed.

As you read this chapter, remember that for every story told here, the majority of survivors never develop a second cancer. The information in this chapter is meant to make you aware, not worried. You can use the information presented here to spark a discussion with your healthcare provider about your individual risk (if any). That knowledge can help you make healthy choices and get appropriate follow-up care to give you the best chance for a long and healthy life.