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Survivorship: During and After Treatment

Lowering the Risk of Getting a Second Cancer

While it's not possible to predict who might get a second cancer, it’s very important that cancer survivors understand their risk for future health problems and second cancers. Talk with your health care team about what problems you might need to watch for more closely. Ask if there are things you can do that might lower your risk, or if there are recommended follow-up tests and screening tests that look for problems. This post-treatment follow-up is often called surveillance.

Importance of follow-up

Once treatment is completed, or if you're on extended treatment such as hormonal therapy, be sure to keep any follow up appointments. Let your health care team know if you have any new symptoms or problems, because they could be caused by a new or existing cancer or non-cancer related problem.

A survivorship care plan should be offered to all cancer survivors. This document summarizes treatment, and helps to coordinate care and give information to the patient and their entire health care team about what is needed after cancer treatment is complete.

Health and cancer screenings

A survivorship care plan should include the need for long-term follow-up care and that screens and monitors for post-treatment symptoms, recurrence, and second cancers. It should list what doctor will do the monitoring and ordering of tests. For example, sometimes there are specific lifestyle recommendations and monitoring needed if a person has certain non-cancer health problems that might affect them after treatment.

To monitor for second cancers, a survivor might have special cancer screening guidelines based on their level of risk or if they have a family cancer syndrome. But, in general, survivors should continue to follow the American Cancer Society guidelines for the early detection of cancer.

Healthy habits

To help maintain good health, survivors should also:

  • Know their medical and family history and risks.
  • Get regular follow-up care and cancer screening.
  • Stay away from tobacco.
  • Get to and/or stay at a healthy weight.
  • Get moving with regular physical activity, and limit the time you spend sitting or lying down.
  • Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains. Also avoid or limit red or processed meats, highly processed foods, and sugary drinks.
  • It's best not to drink alcohol. If you do drink, have no more than 1 drink per day for women or no more than 2 drinks per day for men.

These steps may also help lower the risk of some other health problems.

For more information about follow-up care and second cancers after treatment for specific types of cancer, see each cancer type.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

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American Cancer Society (快猫短视频).  Cancer Prevention and Early Detection Facts & Figures, 2019-2020. Atlanta, GA: American Cancer Society; 2019.

American Cancer Society (快猫短视频). Cancer Treatment and Survivorship Facts & Figures 2019-2021. Atlanta, GA: American Cancer Society; 2019.

Division of Cancer Epidemiology and Genetics (NIH). Second primary cancers. Accessed at https://dceg.cancer.gov/research/what-we-study/second-cancers on September 19, 2019.

Fung C, Bhatia S, Allan JM, et al. Second cancers. In DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2019:2155-2173.

Rock CL, Thomson C, Gansler T, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA: A Cancer Journal for Clinicians. 2020;70(4). doi:10.3322/caac.21591. Accessed at https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21591 on June 9, 2020.

Rowland, JH, Mollica, M, Kent EE. Survivorship. In Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:732-740.

Last Revised: June 9, 2020

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