Can You Get Two Cancers on the Same Time?

Jennifer Schmid had simply realized she had pancreatic most cancers and that she would want surgical procedure to take away a part of her pancreas, abdomen, and intestines. Schmid’s oncologist really helpful she have a CT scan to examine for most cancers wherever else in her physique.

That’s how medical doctors discovered the spot on her lung.

To 61-year-old Schmid, of Newhall, CA, this information sounded about as unhealthy because it might get. The pancreas most cancers should have been so superior that it had already unfold to her lungs, she thought. But that wasn’t the case.  

 

 

Schmid’s oncologist ordered genetic sequencing of each the lung tumor and the pancreas tumor. That’s a check to learn the distinctive DNA of every tumor. It revealed that the 2 tumors have been utterly totally different from one another. Schmid didn’t have a single superior most cancers that had unfold from her pancreas to her lungs. She had two separate early-stage cancers: lung most cancers and pancreatic most cancers. This made all of the distinction in Schmid’s remedy and long-term prognosis.

“It was a stroke of luck that they found that spot on my lung and that they figured out it was not a metastasis,” Schmid says.

Two separate major cancers, versus one which has unfold to a number of components of the physique, require totally different remedy and, in lots of instances, can include a much better outlook than a single metastatic most cancers. And it occurs extra typically than individuals may assume. 

How Common Is It? 

While it could appear to be a uncommon case of lightning placing twice, it’s not terribly unusual for an individual to get two major cancers – even on the similar time. 

Researchers estimate that about 1 in 20 individuals with most cancers have one other separate most cancers on the similar time. They outline “at the same time” as two tumors occurring inside lower than 6 months of one another. It’s much more frequent to have two totally different cancers at separate occasions – that’s, a second most cancers greater than 6 months after the primary. This occurs in as much as 1 in 5 individuals who have had most cancers. 

Lauren Stevens of Louisville, OH, was a type of 1 in 5. She had lived with a mind tumor from 2004 to 2019. Her physician monitored it with routine scans and so long as it didn’t develop, they selected to not function. A scan in 2019, nevertheless, confirmed that it had began to develop – and quick. 

Stevens, now 50, had surgical procedure to take away many of the tumor adopted by radiation and chemotherapy. Then she resumed routine scans to observe the remaining tumor that the surgeon wasn’t in a position to take away. 

Continuing to stay with an inoperable mind tumor, Stevens began seeing blood in her stool. A colonoscopy and biopsy revealed that she had colon most cancers. Soon, Stevens was again in chemotherapy and radiation adopted by surgical procedure to deal with this second most cancers whereas nonetheless dwelling with the primary. 

Understandably, dwelling with most cancers since she was 32 years outdated has been daunting for Stevens. There have been occasions when she wished to surrender and now not pursue the really helpful care. But 7 years in the past, she acquired a brand new cause to stay.

“I have a grandson now,” she says. “He just turned 7. I didn’t know my grandparents growing up. I want my grandson to remember me. We’re very close. I think the sun just rises and sets on him.”

Who Gets Cancer Twice?

Anyone who has had any kind of most cancers might get a second most cancers of any kind. But analysis reveals that those that’ve had bladder most cancers or non-Hodgkin’s lymphoma are at best danger for second cancers. Lung most cancers seems to be the most typical second major most cancers. 

There are numerous the explanation why an individual may develop two separate major cancers of their lifetime. 

Chance. Anyone is susceptible to growing most cancers at any given time. You have a lifetime danger, for instance, for lung most cancers and a separate danger for, say, colorectal most cancers. So whereas it’s much less frequent than having simply a type of cancers, it’s doable that you would get each. 

Genetics. You can inherit genes out of your dad and mom that increase your danger for particular cancers. Mutations within the BRCA1 and BRCA2 genes, for instance, that you just inherit from a mum or dad increase your danger for breast most cancers (in addition to ovarian and pancreatic cancers). You may also inherit a gene that raises your danger for colorectal most cancers. This genetic predisposition known as Lynch syndrome. 

“This is why it’s important to have genetic testing to look for one of these syndromes if you have two primary cancers,” says Joleen Hubbard, MD, an oncologist at Mayo Clinic. “There are many that we can test for, but there are also probably many cancer syndromes that we aren’t aware of yet.” 

Common danger elements. Many elements that increase your danger for one most cancers increase your danger for others as effectively. Smoking and tobacco use, for instance, trigger at the least 14 various kinds of most cancers. Obesity, alcohol use, and an unhealthy food regimen are different danger elements for a number of totally different sorts of most cancers. Exposure to dangerous substances within the atmosphere can increase danger for multiple kind of most cancers, too. 

Previous most cancers remedy. Radiation and chemotherapy for one most cancers can increase the danger for one more most cancers down the road. But medical doctors don’t sometimes name these cancers second major cancers. They are radiation-induced or chemotherapy-induced secondary cancers. 

How Do Doctors Diagnose Two Separate Cancers?

With many cancers, whenever you get a analysis, the physician will order imaging of your chest, stomach, and pelvis to see if the most cancers has unfold past the place it began. For cancers that generally unfold to the mind, reminiscent of lung most cancers, testing may embody mind imaging, too. 

If further tumors present up in these photos, they could comprise clues as to whether or not they arose from the identical most cancers or a special one. 

 

 

“If you have a patient that has two separate masses and they look different on a PET scan – one lights up more than the other – that raises our suspicion that they might not be the same malignancy, which would require us to sample both areas,” says Arsen Osipov, MD, the oncologist who managed Schmid’s care at Cedars-Sinai Cancer in Los Angeles. He runs the Pancreatic Cancer Multidisciplinary Clinic.

A biopsy and genetic sequencing of each tumors, like Schmid had, can inform medical doctors definitively whether or not they’re one most cancers or two. 

“Finding out whether a person has two primary cancers versus a single cancer that has metastasized is critically important,” Osipov says. “It could have been assumed that she had metastatic pancreatic cancer, but actually she had two separate cancers that could each be treated definitively with the intention to cure. You take care of one, then the other, and those cancers are not as advanced as a single cancer with metastasis would have been.”

What’s the Treatment for Two Separate Cancers?

When two totally different cancers come up on the similar time, medical doctors should make a judgment name: Which most cancers ought to they deal with first? 

In uncommon instances, the 2 cancers could share traits that might make them reply to the identical focused drug or chemotherapy routine. 

“This would be an ideal scenario, but it’s very rare,” Osipov says. 

When two simultaneous major cancers require two totally different remedies, Hubbard says, “You’ll either treat the most life-threatening cancer first or sometimes it may be best to treat the one that’s easiest to treat first.” 

Schmid had stomach surgical procedure first for the pancreatic most cancers after which radiation and chemotherapy for her lung most cancers. The chemotherapy remains to be in progress. 

What If It Happens to You?

If you get a analysis of metastatic most cancers, be sure to get a biopsy of the metastases to be sure to don’t have two separate cancers.

“Most centers are already doing this,” Hubbard says, “and this is why your doctor needs to biopsy a metastatic site.”

Osipov recommends that folks with two simultaneous major cancers get care at a most cancers middle the place they’ll work with a multidisciplinary staff that features oncologists, surgeons, radiologists, and pathologists who can all work collectively in your case. Keep in thoughts that oncologists are likely to specialise in explicit varieties of most cancers, so in case you have multiple kind of most cancers, you’d desire a staff of oncologists at a most cancers middle to find out which most cancers to deal with first.

At the least, Hubbard provides, sufferers with two cancers ought to get a second opinion on their analysis and care.

“This helps not only the patient but the primary treating oncologist have a better idea of what tumors they are dealing with, what treatment options are available, and the best order in which to treat the cancers.”