Post-Prostate Cancer Care: A Second Cancer?

You may be told that your prostate cancer is in remission and you are about to embark on the road to recovery. The post-treatment follow-up usually includes side effects management, monitoring for prostate cancer recurrence and early detection of second cancer.

Yes, second cancer – a new cancer unrelated to the prostate cancer you had before. Cancer that returns after treatment is called a recurrence, while a new cancer at a different site is called a second cancer.

Unfortunately, having had prostate cancer does not make you resistant to other types of cancer. Factors that increase your likelihood of having a second cancer include:

• Old age
• Having undergone radiation therapy that has damaged nearby organs (e.g. the bladder or rectum)
• Other risk factors like smoking, genetics (e.g. BRCA1/2, hereditary Lynch syndrome) or obesity

While it is nearly impossible to completely prevent any type of cancer, you can, however, lower your odds of a second cancer by understanding your risk factors, boosting your overall health, adopting lifestyle changes and taking medical precautions, if necessary. Continue to monitor your health for any changes because early detection can significantly improve your outlook, in the event of a second cancer.

Any cancer can develop after the treatment. However, certain risks are heightened by prostate cancer, especially if radiation therapy was part of the treatment. Although the overall risk is generally low, it is good to be aware of the signs and symptoms of any second cancer. Some signs and symptoms of common second cancers after prostate cancer include:

• Small intestine cancer – stomach cramps, nausea and vomiting, bloody stool
• Bladder cancer – bloody urine
• Rectal cancer – stomach bloating and cramps, changes in bowel habits (diarrhea or constipation) that persist over a long period, bloody stool, unexplained weight loss

Pelvic radiation therapy may increase the risk of bladder and rectal cancer. Individuals who have undergone radiation therapy should:

• Be informed about this risk by their doctors
• Undergo routine screening for rectal cancer
• Undergo appropriate evaluation if there are any signs or symptoms of either cancer

Certain second cancers can even occur in areas far from the prostate, such as

• Thyroid cancer – lump or swelling in the neck, difficulty swallowing, difficulty breathing
• Thymus cancer - cough, shortness of breath, difficulty swallowing, chest pain

It is important to understand that the risk of developing a second cancer is generally low, and the benefits of treating the initial prostate cancer often outweigh the potential risks. Regular follow-up appointments and discussions with your healthcare providers can help address your risks and develop a personalized care plan.