Guidelines for Complications of Cancer Treatment Vol VIII Part B

Conclusion:Incidence of SMN is increasing with improved cancer survival,better awareness, and closer surveillance and rigorous followup.Contrary to popular belief all SMN cannot be attributed toradiation therapy, rather aetiology of SMN is a complexinteraction of various host and treatment related factors. Stillthe risk of malignancy development following irradiation islow and should be weighed against the risks of death andcarcinogenicity from other factors, toxicity of chemotherapy,morbidity and mortality of surgery, and existing alternativesto radiotherapy in the treatment of cancer patients. Potentialcarcinogenicity should not be regarded as a contraindicationto the use of radiotherapy. With the increasing incidence ofSMN, there is a need for population-based registries todocument, analyse, and interpret the data pertaining to theseSMN. Risk of SMN is not equal among all cancer patients.There is need to develop methods to identify patients at highrisk of SMN based on molecular and genetic factors. Thesehigh-risk subgroups should be counselled about the risk ofSMN, regarding life-style modification (eg. smoking cessation,high-fibre & low-fat diet, regular physical exercise etc.) andclose long-term follow up. The options of early and frequentscreening and chemoprevention strategies also need to beevaluated appropriately.References:1. Ries LAG, Harkins D, Krapcho M, et al., (eds). 2006.SEER Cancer Statistics Review, 1975-2003. Bethesda,MD, National Cancer Institute. Available at http://seer.cancer.gov/csr/1975_2003/, based on November2005 SEER data submission, posted to the SEERwebsite, 20062. Curtis RE, Freedman DM, Ron E, et al. NewMalignancies Among Cancer Survivors: SEER Cancer289