Multiple Primary Cancers in Female Cancer Patients

Abstract

During the period July 1976 to December 1989, there were 318 multiple primary cancers among 13,743 female cancer patients (2.3%) seen at this hospital. Fourteen of 318 patients had 3 or more than 3 primary cancers. The ten most frequent female multiple cancers are those arising from cervix uteri, breast, colon, nasopharynx, kidney, bladder, rectum, thyroid, lung and stomach. The primary cancers most likely to develop a second primary cancer are kidney (7.5%), bladder (6.7%), vagina and vulva (5.2%), oral cavity (4.4%), colon (4.1%), breast (3.9%), corpus uteri (3.3%), larynx (2.8%) and cervix uteri (2.7%). Cervical cancer is frequently followed by a second cancer arising from lung, breast, urinary bladder, nasopharynx, colon, rectum, bone marrow and the reticuloendothelial (B.M. & R-E) systems (in the order of decreasing frequency). Corpus cancer usually co-exists with an ovarian cancer. Vaginal and vulvar cancers are also followed by a second cancer arising from the cervix. Breast cancer is frequently followed by a second cancer arising from the contralateral breast, cervix uteri, skin, lung, colon, esophagus or kidney. Colon cancer is frequently followed by a second cancer arising from the gastrointestinal tract (different sites of the colon, rectum, stomach, liver), breast and urogenital organs (cervix uteri, corpus uteri, and. bladder). Nasopharyngeal cancer is frequently followed by a second cancer arising from oral and nasal cavities (tongue, palate, oropharynx, nasal cavity) and gastrointestinal tract (colon, stomach, liver), breast, cervix uteri and skin. Kidney or bladder cancer is frequently followed by a second cancer arising from urogenital organs (kidney, bladder, cervix uteri and corpus uteri). Duration between the occurrence of the first primary and the second primary cancers ranged from 0 to 386 months with a median duration of 31 months. The percentage of patients given radiotherapy and/or chemotherapy for the first cancer was 54.6% (131/240). In the present study, only the association of radiotherapy was observed; the carcinogenic effect of chemotherapy or a combination of radiotherapy and chemotherapy can not be demonstrated. If the duration between the occurrence of the first and second cancer was less than two months or more than five years, the five-year survival rate is better (52.8% or 47.8%, respectively); but if the duration was above two months and less than five years, the five year survival rate is lower (33.6%).