Can We Lower the Risk of Second Cancers?

Linda Lewis, former editor of More and Today’s Parent magazines, Canada. (Photo credit: John Van Der Schilden)

The world lost a bright star in journalism recently when Canadian Linda Lewis, former leading magazine editor, died at 52 from complications of myelofibrosis. In reading her obituary it’s clear she was a warm, caring person – mother of two – who loved life and, as the cancer diagnosis set in, the spontaneity of enjoying the moment.

Linda’s myelofibrosis had transformed into acute myeloid leukemia and that took her life. But one wonders if the stage was set years before when, at age 39, she was treated for cervical cancer. The treatment included chemo and radiation and Linda’s doctors in Toronto apparently think that led to the myelofibrosis – scarring in the bone marrow – years later.

The latest buzz is about chemo-free treatments for some cancers – targeted therapies that turn off a cancer causing mutation or limit a protein that allows cancer cells to survive. The belief is these will be much less toxic with little or no damage to healthy cells – including the ones in bone marrow, the blood factory. Certainly we’ve been told that people who develop cancer had an immune system that somehow let them down and allowed cancer cells to grow and proliferate and that, even after treating the first cancer, the immune system might fail again leading to a new, second cancer. Cancer might be that person’s Achilles heel.

But, to be sure, too many second cancers have been caused by treatment for the first one. The treatment beat back cancer number one but caused collateral damage and starting a time bomb ticking. Most of us who have been treated for cancer, even when the regimens are hard (and they usually have been), are grateful for being given more years of life. And as therapies have been improved, many of us have seen very long remissions. As cancer therapy becomes more refined, and more targeted, my hope is the chances of another cancer shoe dropping years in the future will be less of a reality.

To be transparent, I am living with a second cancer, also myelofibrosis. And fortunately the symptoms are well controlled with a new medicine. Whether AML lies in my future I do not know. All any of us have is today.

Was the myelofibrosis caused by the chemo I had for chronic lymphocytic leukemia (CLL) in 2000? We know some of the drugs in the “cocktail” I received “hammered” the bone marrow. That was a risk then and still is for people who receive that same standard regimen, FCR. But it has given me 13 years with no more treatment for CLL, and I’ve enjoyed every minute of those years.

I didn’t expect a second cancer diagnosis, for me it came out of nowhere. I bet it was the same for Linda Lewis. Looking forward let’s hope today’s patient who receives an unfortunate cancer diagnosis can benefit from the latest treatments and not face a second cancer down the line.