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- Asymptomatic coronary artery disease
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- Central precocious puberty – CPP
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- Craniofacial growth problems
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- Male fertility problems, testosterone deficiency and sexual dysfunction
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- Peripheral neuropathy
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- Psychosocial problems
- Spine scoliosis and kyphosis
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- Subsequent neoplasms:
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SUBSEQUENT NEOPLASMS: LUNG CANCER
This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.
On this page you can find:
This brochure is a sequel to the brochure Subsequent neoplasms: general. Please read that brochure first before you continue.
This PLAIN summary is based on the PanCareFollowUp guideline about “Subsequent neoplasms” [1], which is based on the consensus of different national guidelines.
PLAIN version 2.1: 27/05/2024
Subsequent cancer: lung cancer
Our lungs are important for breathing. When we breathe in, tiny air sacs in the lungs take up oxygen, which is then transported through the bloodstream to all parts of the body. When we breathe out, carbon dioxide is removed from the blood and released into the air.
Sometimes, the cells that make up the lungs can become malignant. This means that they do not work properly anymore and multiply uncontrollably, causing a tumour to grow. When this happens, this is called lung cancer.
Only a very few people who have had cancer before develop lung cancer.
Due to treatment of the first cancer, survivors sometimes have a higher risk of lung cancer. There are a number of things anyone can do to lower the risk of having lung cancer, such as avoiding smoking.
The lungs
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Hover over the numbers in the figure for more information.
Lung cancer
Survivors
Am I at higher risk of lung cancer?
Anyone, including people who have never had cancer treatment, may develop lung cancer. However, there are some cancer treatments that may increase the risk of having lung cancer as a subsequent cancer later in life.
The following treatment can increase the risk of lung cancer:
- Radiotherapy to the lungs or an area that includes the lungs
You can find out if you have received radiotherapy to the lungs by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.
If you develop lung cancer, it does not always mean that this is caused by treatment for your first cancer. Lung cancer may have other causes, such as (second hand) smoking, being exposed to polluted air or working with harmful substances.
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all.
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
What are the symptoms and signs of lung cancer?
There are symptoms and signs that can tell you if you might have lung cancer. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.
These symptoms and signs may suggest that you have lung cancer:
- Having a cough for longer than 3 weeks.
- Repeated infection in the chest.
- Coughing up blood.
- Chest pain when breathing or coughing.
- A (usually painless) lump in the neck.
- Shortness of breath.
- Unexplained hoarseness.
Very often these symptoms have another cause, such as a lung infection. However, early diagnosis and treatment of lung cancer is very important. If you experience any of these symptoms or signs, please contact your general practitioner or follow-up care specialist soon.
Symptoms and signs
Soon
I am at higher risk of lung cancer. What tests should I have and when?
paediatric
X-ray
In addition, there is also the option of CT (computer tomography) and MRI that are giving a more detailed look. The choice of imaging depends on what exactly needs to be looked at or examined. These images are used by healthcare professionals to make diagnoses or create treatment plans.
Fibroscopy / Bronchoscopy
What happens if I (might) have lung cancer?
If you (might) have lung cancer, your general practitioner or follow-up care specialist will refer you to an oncology team. This team may include, but is not limited to:
- Chest physician (physician specialised in diseases in the area of the chest)
- Thoracic surgeon (surgeon specialised in the area of the chest)
- Medical oncologist (physician specialised in cancer)
- Radiation oncologist (physician specialised in treating cancer with radiotherapy)
The specialist may discuss different treatment options with you.
What else can I do?
Knowing that you may be at increased risk of subsequent cancer can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.
To lower your risk of lung cancer, adopting or maintaining a healthy lifestyle is extremely important. In particular, it is important to avoid smoking (cigarettes, vapes, cigars, pipes and breathing in second-hand smoke) and being exposed to polluted air or working with harmful substances. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.
It is important that you are aware of the possibility of developing lung cancer and that you know the symptoms and signs. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.
Healthy lifestyle
- Having a healthy diet
- Drinking less (or no) alcohol
- Exercising regularly
- Quitting smoking (if you smoke)
Your follow-up care specialist or general practitioner may give you additional advice tailored to your individual situation for maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.
Second-hand smoke
Like smoking yourself, second-hand smoke also is harmful and can cause health problems later in life. Especially, if you are at higher risk of certain late effects (subsequent lung cancer or lung problems) it is extremely important to avoid second-hand smoke.
Where can I find more information?
You may find more information about lung cancer online. However, it is important to be aware that this information is not always up to date or accurate.
On this website, you can also find more information related to this topic:
Please note
This PLAIN summary is based on the PanCareFollowUp guideline about “Subsequent neoplasms” [1], which is based on the consensus of different national guidelines.
While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.
Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.
No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.
The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.
[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.