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When cancer is a side effect of cancer

Childhood cancer survivor Tori Tomalia was diagnosed with stage 4 lung cancer two years ago. While her doctors believe the two cancers are unrelated, many childhood cancer survivors are diagnosed with second cancers brought on by treatments like radiation.
Photo courtesy of Tori Tomalia

Survivors of childhood cancer are twice as likely as the general population be diagnosed with cancer after age 40, according to a new study from the University of Minnesota and Fred Hutch.

Pam Gillespie didn’t just beat cancer as a 12-year-old. She did it again at age 22. And yet again at age 42.

“In 1976, I was diagnosed with Hodgkin’s disease,” said Gillespie, now 51. “They took out my spleen and gave me strong doses of radiation from the chest up. In 1986, I was diagnosed with thyroid cancer from all the radiation to my chest, so they took out my thyroid. [Then] in 2006, they found breast cancer.”

Tori Tomalia also got hit with a cancer “double whammy.” At 14, she was diagnosed with osteogenic sarcoma, a form of bone cancer. Two years ago at age 37, the mother of three was diagnosed with stage 4 lung cancer.

“Once I was ten years out, they felt that I was cured so the lung cancer thing took us completely by surprise,” Tomalia said. “I couldn’t believe it, especially being a nonsmoker.”

A second (or third) primary cancer diagnosis — that is, a new cancer unrelated to the first — is common among childhood cancer survivors. A new study by Dr. Lucie Turcotte from the University of Minnesota and Fred Hutch researchers Dr. Wendy Leisenring and John Whitton sheds light on just how common.

Survivors of childhood cancer are twice as likely as the general population be diagnosed with cancer after age 40. Even more distressing, the researchers discovered that if childhood survivors were diagnosed with a second cancer before age 40, they were even more likely to develop a third.

Double-edged sword

Dianne Mackay, a marketing manager from Burnaby, British Columbia, also beat cancer twice: first a Wilms tumor, a type of kidney cancer, when she was 14, and later breast cancer in her early 40s.

“In some ways the fact that I had been through it all those years earlier meant that I knew what to expect, and that’s a double-edged sword,” she said. “Knowing what to expect, you don’t have a lot of surprises, but I knew that it was going to be a really long haul.”

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