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Second Malignant Neoplasms

Another serious concern is the development of a second malignant neoplasm. This can develop due to genetic susceptibility (family history) and/or the use of chemotherapeutic drugs (or radiation in the rare cases that it is used). It is important to receive good follow up care and regularly check the recommendations put out by such organizations as the Children's Oncology Group so that if a second cancer occurs, you can detect them early. The overall risk is about 3 times higher compared to your age group, which is not very high.

Risk factors that increase your chance of a second malignant neoplasm include:

• Family history of bone tumors, breast cancer, soft tissue sarcoma, brain tumors, and leukemia or history of p53 mutations, Li-Fraumeri Syndrome, Rothmund Thomson Syndrom or Werner Syndrome.
• The chemotherapeutic agents Ifosphamide and Etoposide used in some protocols have a higher risk of secondary leukemia. This is tested for in the yearly recommended blood test (CBC).
• Radiation, which is rarely used in osteosarcoma, increases the risk. Yearly physical examinations are recommended.