Author: Pan D (Guangdong Provincial People’s Hospital)
Are people with other cancers more likely to get lung cancer? This risk exists. Let’s discuss.
I. What is multiple primary tumor?
The same person has two or more primary malignant tumors that are unrelated to each other at the same time or in succession. Secondary cancer, repeat cancer, etc.
They can originate from the same organ, pairs of organs, different parts of the same system, or different organs of different systems [1].
Image source: Zhanku Hailuo
The following three conditions are met for doctors to judge them as multiple primary tumors:
Each tumor must be histologically confirmed malignant;
Each tumor occurs in different parts of the same organ, or in different organs;
New tumors cannot be metastases from primary cancers in other organs. For example, if lung cancer metastasizes to the liver, the liver cancer is still lung cancer, which does not meet the diagnostic criteria for multiple primary tumors.
The time interval between the discovery of two primary malignant tumors can be divided into simultaneity and metachronism. The former refers to occurring at the same time or within 6 months; the latter refers to occurring at different time points over 6 months [1].
Therefore remind you that if there are tumors in multiple parts (organs), don’t just think about the metastasis of malignant tumors, but also need to combine clinical, imaging, pathological, etc. means to comprehensively judge whether there is the possibility of multiple primary tumors, because the treatment plans are also different.
Domestic studies have shown that lung adenocarcinoma is the most common among patients with multiple primary tumors, and the digestive system is another major predisposing site.
Smokers are more likely to develop multiple primary tumors, including lung cancer. The survival rate of lung cancer is lower than that of other cancers [2].
Image source: Zhanku Hailuo
2. Patients with other malignant tumors are more likely to develop new malignant tumors
Studies have shown that patients who have already developed a malignant tumor are 1.29 times more likely to develop a new, independent primary malignant tumor than normal people [3].
However, the relationship between the two is still unclear in professional circles. It is generally believed that multiple primary cancers occur because carcinogenic factors have effects and effects on adjacent organs with similar histological structures.
From a genetic point of view, if you have other tumors and have gene mutations that are trigger points for lung cancer, it is easy to induce lung cancer.
Therefore, if you already have a certain malignant tumor, you should strengthen regular inspection and follow-up, and timely diagnosis and treatment.
Image source: Zhanku Hailuo
Joint review: Dr. Chen Zhiyong, Guangdong Provincial People’s Hospital, Guangdong Lung Cancer Research Institute
Co-author: Dr. Ma Yue, Department of Oncology, Renji Hospital Affiliated to Shanghai Jiaotong University
References:
[1] Warren S,Gates O.Multiple primary malignant tumors: a survey of the literature and statistical study[J].Am J Cancer,1932,16:1358.
[2] Ao Ting, Sun Junping, Zhang Mingyue, et al. Analysis of the incidence characteristics of 55 cases of lung cancer combined with other primary malignant tumors [J]. Journal of the PLA Medical College, 2016, 37(3) :226-228.
[3] Schoenberg BS. Multiple primary malignant neoplasms. The Connecticut experience. 1935-1964[J]. “Recent Results Cancer Res”, 1977, 58:1-173.
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