A new study has revealed that nearly 8% of survivors of non-small cell lung cancer (NSCLC) develop secondary cancers that are not in the lungs, and about 13.5% experience a recurrence of their lung cancer over nearly six years of follow-up. The study also found that certain genetic factors increase the risk of developing non-lung secondary cancers.
Study Details
NSCLC survivors continue to face the possibility of recurrence and secondary cancers, but research on non-lung secondary cancers has been limited. To address this gap, researchers studied 496 survivors of stage I-III NSCLC who had been treated with curative-intent local therapy. The patients, with a median age of 69, were monitored at a dedicated survivorship clinic at a major cancer center between January and May of 2019.
The study aimed to understand the rates and timing of recurrence, non-lung secondary cancers, and death. The median follow-up time was 71.6 months.
Study Results
13.5% of patients (67 out of 496) experienced recurrence of NSCLC.
23.4% (116 out of 496) developed secondary cancers, including 15.5% with new lung cancers and 7.9% with non-lung cancers.
The most common non-lung secondary cancers were breast (15.4%), prostate (12.8%), pancreatic (12.8%), and head and neck cancers (12.8%).
The 5-year cumulative risk of non-lung secondary cancers was 5.6%, compared to 11.5% for recurrence of NSCLC.
Interestingly, most non-lung cancers (69.2%) were detected due to symptoms, with 30.8% found incidentally. None of the non-lung secondary cancers were detected through population screening. The two-year overall survival rate after a non-lung secondary cancer diagnosis was 73.3%, but 20.5% of these patients presented with metastatic disease.
Genetic Risks
Having a hereditary syndrome or certain genetic mutations was found to significantly increase the risk of developing non-lung secondary cancers. However, smoking history did not seem to play a significant role in increasing this risk.
Clinical Recommendations
The study’s authors recommend a personalized approach to long-term care for NSCLC survivors. This approach should include regular thoracic imaging, genetic assessments when necessary, and age-appropriate cancer screenings. They also emphasize the importance of remaining vigilant for any new symptoms outside the lungs.
Study Limitations
The study only included patients from a single academic center and may not be applicable to all populations. Additionally, the data on how patients adhered to follow-up visits and imaging was inconsistent, which may have impacted the detection of secondary cancers.
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