(21 Aug 2015) LEAD-IN:
Secondary cancers are on the rise, affecting nearly one in five patients in America.
Doctors say while a reoccurance of the disease is a matter of concern, it is still possible to survive.
STORY-LINE
Judith Bernstein is a beacon of hope to patients who've seen their cancers return.
She holds a treasured present, with a Hebrew inscription which she chants: "God send healing now."
The 72 year old has had eight types over the last two decades, all treated successfully.
Second cancers refer to more than one tumours in different tissue types or a different site, not a recurrence or spread of the original tumor.
Bernstein admits she's an extreme example as she lists the different cancers: "Skin, lymphoma, breast, lung, lung, followed by esophageal."
She then remembers another: "And that was followed by thyroid, partial thyroidectomy."
Almost every part of Bernstein's body has been affected including her little finger and there was a rare tumor on one of her eyelids
A study shows almost a fifth of all US cancers have been experienced by a patient more than once.
Bernstein describes her predicament as: "Dumb luck".
It's also been an emotional burden to her husband Arnold who says he's had: "Many sleepless nights. Why? I was watching her to make sure she was breathing."
Psychologically, a second cancer often is more traumatising than the first for patients and families.
Bernstein has been treated here at the Fox Chase Cancer Centre.
Since the 1970s when second cancers appeared in just 9 per cent of patients, the numbers have risen.
Clinicians say this is partly a success story.
It shows more people are surviving cancer and living long enough to get it again, because the risk of cancer rises with age.
Second cancers also can arise from the same gene mutations or risk factors, such as smoking, that spurred the first one.
Even some treatments like radiation therapy which help people survive their first cancer can increase the risk of a new cancer forming later in life
One of the centre's doctors is Eric Horwitz.
He says: "Sometimes you're at risk for getting another cancer because of the previous one you had. But other times, you're cured of your first cancer and you're just at risk like the normal population for getting a different cancer."
Horwitz has cause for optimism.
He says: "The treatments themselves have gotten much, much better over the years and they're much, much more sophisticated. It's allowed us to effectively treat a person more than one time."
Despite her cancers Bernstein exercises to keep her resillient.
Medically, second cancers pose special challenges.
Treatment choices may be more limited. For example, radiation usually isn't given to the same area of the body more than once.
Some drugs also have lifetime dose limits to avoid nerve or heart damage.
Experts have this advice for cancer survivors:
Staff here on the cemotherapy ward have advice for patients.
They say patients should be prepared with blueprint for the future that includes a detailed summary of the treatment they've received and the monitoring they need.
Being alert to symptoms is important and keeping screening appointments is essential.
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