If I’m diagnosed with one cancer, am I likely to get another?
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Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health.
Fear of cancer returning is one of the top health concerns. And managing this fear is an important part of cancer treatment.
But how likely is it to get cancer for a second time?
Why can cancer return?
While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms.
This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called metastasis.
Actor Hugh Jackman has gone public about his multiple diagnoses of basal cell carcinoma (a type of skin cancer) over the past decade.
The exact reason why cancer returns differs depending on the cancer type and the treatment received. Research is ongoing to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people.
What are the chances of cancer returning?
The risk of cancer returning differs between cancers, and between sub-types of the same cancer.
New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by 31-68%. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning.
For most types of cancer, the highest risk of cancer returning is within the first three years after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning.
Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed.
What about second, unrelated cancers?
Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) shortly after being treated for breast cancer.
Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one.
Australian research from Queensland and Tasmania shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population.
Who’s at risk of another, unrelated cancer?
With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer.
Reasons for such cancers include different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors.
The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is relatively small when compared with the (sometimes lifesaving) benefits of these treatment and procedures.
While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years.
Similarly, in a large US study only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years).
The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer.
People diagnosed with cancer as a child, adolescent or young adult also have a greater risk of a second, unrelated cancer.
What can I do to lower my risk?
Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment.
Maintenance therapy may be used to reduce the risk of some types of cancer returning. However, despite ongoing research, there are no specific treatments against cancer recurrence or developing a second, unrelated cancer.
But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of cancer returning and getting a second cancer.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and Terry Boyle, Senior Lecturer in Cancer Epidemiology, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Little-Known Truth…
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Myth-Buster, Myth-Buster, Bust Us A Myth (or three!)
Let’s can this myth for good
People think of “canned foods” as meaning “processed foods” and therefore bad. But the reality is it’s all dependent on what’s in the can (check the ingredients!). And as for nutrients?
Many canned fruits and vegetables contain more nutrients than fresh ones! This is because the way they’ve been stored preserves them better. For example:
- Canned tomatoes contain more bioavailable lycopene than fresh
- Canned spinach contains more bioavailable carotene than fresh
- Canned corn contains more bioavailable lutein than fresh
- The list goes on, but you get the idea!
Don’t Want To Take Our Word For It? Read The Scientific Paper Here!
Gaslight, Gymkeep, Girl-loss?
Many women and girls avoid doing weight-training as part of their exercise—or use only the smallest weights—to avoid “bulking up” and “looking like a man”.
Many men, meanwhile, wish it were that easy to bulk up!
The reality is that nobody, unless you have very rare genes, packs on a lot of muscle by accident. Even with the genes for it, it won’t happen unless you’re also eating for it!
Resistance-based strength training (such as lifting weights), is a great way for most people to look after an important part of their long-term health: bone density!
You can’t have strong muscles on weak bones, so strengthening the muscles cues the body to strengthen the bones. In short, your strength-training at age 45 or 55 (or earlier) could be what helps you avoid a broken hip at 65 or 75.
We’re Not Kidding, It Really Is That Important (Read The Study Here)!
Something doesn’t smell right about this
There’s been a big backlash against anti-perspirants and deodorants. The popular argument is that the aluminium in them causes cancer.
This led to many people buying “deodo-rocks”, crystal rocks that can be run under water and then rubbed on the armpits to deodorize “naturally”. But, those crystal rocks are actually alum crystals (guess what they contain…).
The belief that deodorants cause cancer came from studies done by applying deodorant to cells (like the canine kidney cells in this study) in petri dishes. So, assuming you don’t cut out your kidney and then spray it directly with the deodorant, the jury is still out!
A more recent systematic review sorted out quite clearly the ways in which aluminium was, or was not, harmful, and said:
❝Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of Alzheimer’s Disease or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic.❞
Critical Reviews in Toxicology
…but also says that you should avoid eating aluminium while pregnant or breastfeeding. We hope you can resist the urge.
See The Summary For Yourself Here!
(actually the whole article is there, but we know you value condensed knowledge, so: the abstract at the top will probably tell you all you want to know!)
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Peanuts vs Pecans – Which is Healthier?
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Our Verdict
When comparing peanuts to pecans, we picked the peanuts.
Why?
Peanuts are an oft-underrated nut!
In terms of macros, peanuts have more than 2.5x the protein and slightly more carbs, while pecans have very slightly more fiber and a lot more fat, of which, mostly healthy monounsaturated and polyunsaturated fats, though it’s worth noting that peanuts’ fats are equally healthy and have a similar general profile, just, less fat per 100g than pecans do. There’s a lot going for both of these very different nuts here, so we’ll call this category a tie.
In the category of vitamins, peanuts have more of vitamins B2, B3, B5, B6, B7, B9, E, and choline, while pecans have more of vitamins C and K (of which they are still not a very good source, but peanuts have none so they can technically claim it for those two vitamins); thus, a clear win for peanuts here, especially as most of its vitamins had very large margins of difference over pecans, and peanuts are a good source of all the vitamins mentioned for them.
When it comes to minerals, peanuts have more calcium, iron, magnesium, phosphorus, potassium, and selenium, while pecans have more manganese and zinc. Another win for peanuts!
Adding up the sections makes for a clear win for peanuts, but by all means enjoy either or both (diversity is good), unless you are allergic, in which case, please don’t!
Want to learn more?
You might like:
Why You Should Diversify Your Nuts
Enjoy!
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Finish What You Start – by Peter Hollins
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For some people, getting started is the problem. For others of us, getting started is the easy part! We just need a little help not dropping things we started.
There are summaries at the starts and ends of sections, and many “quick tips” to get you back on track.
As a taster: one of these is “temptation bundling“, combining unpleasant things with pleasant. A kind of “spoonful of sugar” approach.
Hollins also discusses hyperbolic discounting (the way we tend to value rewards according to how near they are, and procrastinate accordingly). He offers a tool to overcome this, too, the “10–10–10 rule“.
Also dealt with is “the preparation trap“, and how to know when you have enough information to press on.
For a lot of us, the places we’re most likely to drop a project is 20% in (initial enthusiasm wore off) or 80% in (“it’s nearly done; no need to worry about it”). Those are the times when the advices in this book can be particularly handy!
All in all, a great book for seeing a lot of things to completion.
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Ear Today, Gone Tomorrow
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Have just had microsuction to remove wax from my ears. A not unpleasant experience but would appreciate your guidance on how best to discourage the buildup of wax in the first place.❞
Well, certainly do not prod or poke it, and that includes with cotton buds (Q-Tips, for the Americans amongst us). That pushes more down than that it extracts, and creates a denser base of wax.
There is no evidence that ear candles help, and they can cause harm.
Further reading: Experts update best practices for diagnosis and treatment of earwax (cerumen impaction)
Ear drops can help, and if you want a home-remedy edition, olive oil or almond oil can be used; these oils dissolve the wax quite quickly (in fancier words: they are cerumenolytic agents); washing with water (e.g. in the shower or bath) is then all that’s needed. However, to avoid infection, ensure you are using a high-purity oil, and get one to use just for that; don’t just grab a bottle from the kitchen.
For your convenience, here is an example of medical grade almond oil (with dropper!) on Amazon
❝Every article had relevance to me. I ❤️ whole fruit, it’s my go to treat. I use ice packs to ease my arthritic knee pain, works well. I’ve read and loved Dr Gawande’s books. Great handful of almonds today❞
While this wasn’t a question, and we don’t usually publish feedback here, I (your writer here, hi) misread that as “ice picks” in the first instance, an implement we’ve probably all wanted to use to relieve pain at some point, but certainly not recommendable! Anyway, the momentary confusion made me smile, so I thought I’d share the silly thought. Smiling is infectious, and all that… And it’s certainly good for the health!
More seriously, glad you enjoyed!
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Magic Pill – by Johann Hari
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Most well-known for his book “Stolen Focus”, this one’s about GLP-1 receptor agonists drugs, their strengths, and their problems.
In this case, Hari himself opted for Ozempic, and this book chronicles his year-long journey on such, his personal experiences, and those he gathered from others along the way.
From a starting position of being a sedentary enjoyer of junk food with 32% body fat and a 40” waist, he was prompted to act after his similarly-aged, similarly-lifestyled friend Hannah died of a heart attack.
Being the science journalist he is, he also takes us through the history of the development of GLP-1 RAs, which sounds like it should be a very dry topic, but actually it’s very engaging reading.
He also talks us through the side effects, and differently than how scientific papers do. We’re accustomed to reading “nausea” and that’s it; instead we get a lengthy description of dry-heaving next to a potted plant in Zürich airport while onlookers assumed he was drunk, we hear about belching up bile, of accidentally taking a double-dose and being too ill to leave the house for several days, making it only the distance from the bed to the bathtub.
We hear, in short, about the disruption to normal life, in a way that adds a little color to the “many people stop because of the side effects”.
A lot of the book is also given over to the psychology and sociology of it, as much as the hard science. Why did the West become fat in the first place; what is driving this change, and are these drugs just a commercial solution to a commercially-made problem, and if so, is that just perpetuating the root cause?
Bottom line: ultimately, this text is both strongly for, and strongly against, GLP-1 receptor agonists. If you’ve been looking for a balanced book on the topic, this is it. And, as users of the new drugs grow in number, some have suggested that it will change humanity to an extent comparable with the invention of the smartphone. So, for or against or a bit of both, it’s good to at least understand them.
Click here to check out Magic Pill, and understand both sides!
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Celery vs Cucumber – Which is Healthier?
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Our Verdict
When comparing celery to cucumber, we picked the celery.
Why?
They are both great, of course! But celery came out on top:
Their macros are very comparable; they’re both 95% water with just enough other things to hold them together, and those other things are in approximately the same proportions in both celery and cucumber.
In the category of vitamins, however, celery has a lot more of vitamins A, B2, B3, B6, B9, E, and K, as well as slightly more vitamin C. Cucumber, meanwhile, only boasts slightly higher vitamin B1.
An easy win for celery on the vitamin front!
Minerals are closer, but celery still comes out on top with its notably higher calcium and potassium content. Cucumber has more iron and zinc, but the margin is smaller.
As a point in cucumber’s favor, it has been noted for its anti-inflammatory effect in ways that celery hasn’t, but we don’t think this is enough to say it wins over celery sweeping the vitamins category and coming out top for minerals too.
However! They are both great, so enjoy them both, of course.
Want to learn more?
You might like to read:
- Cucumber Extract Beats Glucosamine & Chondroitin… At 1/135th Of The Dose?!
- Some Surprising Truths About Hunger And Satiety ← both celery and cucumber are great for this
Enjoy!
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