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Does the amount of chemo you've been treated with affect the risk of developing a second cancer?
That can't be concluded from the results of the current study. The main focus was on which types of chemotherapy affect the DNA and what the exact damage consists of. Second cancers are relatively rare. That means the group of patients was too small to draw conclusions about a link between the dose of chemotherapy and the risk of developing a second cancer.
Is a second cancer something else than a cancer recurrence?
Yes. When the cancer comes back during or after treatment, it is known as a recurrence. That is the original form of cancer which is no longer stopped from growing by the treatment. A second cancer is refers to a truly new, different form of cancer.
Does an alternative form of treatment exist to replace this harmful chemotherapy?
Children with cancer are treated with therapies that have been scientifically shown to work best against cancer, with as little side effects as possible. Childhood oncologists carefully consider the possible benefit of a treatment, weighing it up against its possible harms. Where possible, they will always offer the kindest effective treatment option. Scientific research is helping better understand side effects and late effects, with the aim of developing kinder, less harmful treatments.
Can my child's blood stem cells be studied to see whether this form of DNA damage has occurred in our case?
DNA damage to blood stem cells cannot be studied for individual children who are not taking part in a scientific study looking at this effect. After treatment for leukemia, your child receives follow-up checks. The increased risk of developing a second cancer is a known late effect of treatment, and is one of the things that is monitored in follow-up checks by the pediatric oncologist or in the LATER outpatient clinic.
Has this been studied in other countries? Why was this effect not previously known?
The raised, but still low risk of a second cancer diagnosis is a late effect of leukemia treatment that was previously known. Techniques to analyze DNA are constantly improving. These developments now enabled researchers to uncover part of the cause for the increased risk. The role of accelerated DNA aging in the risk of a second cancer diagnosis had not previously been discovered before, or elsewhere in the world. Scientists across the globe can now carry out follow-up research: for example into ways to pick out children with a high risk of a second cancer, and into the least harmful forms of chemotherapy.