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Second Cancers After Rectal Cancer Treatment: What Patients Should Know

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Development of Second Malignancies Following Chemotherapy With or Without Radiation Therapy for the Treatment of Locally Advanced Rectal. DOI 10.1016j.ijrobp.2025.07.1424

People with advanced rectal cancer often receive chemotherapy, sometimes with radiation. A new study looked at whether these treatments increase the chance of getting another cancer later in life.

The study followed over 2,600 patients with stage II or III rectal cancer for about 6 years. Some had chemotherapy only. Most had both chemotherapy and radiation. The researchers checked how many developed second cancers in the pelvic area or elsewhere in the body.

The risk of a second pelvic cancer was similar for both groups. Radiation did not clearly raise the risk. Most of these second cancers were in the bladder or urinary system. Only a few were rare cancers like sarcoma.

There was more concern with second cancers outside the pelvis. People who had both chemotherapy and radiation had a higher chance of getting cancers in other parts of the body. This was especially true for people over age 50, those with diabetes, and people who smoked. People who did not smoke had a lower risk.

One important finding was that modern radiation methods, like intensity-modulated radiation therapy (IMRT), may lower the risk of second pelvic cancers compared to older techniques.

If you’ve had treatment for rectal cancer, regular checkups are key. Staying healthy—avoiding tobacco, managing diabetes, and talking to your doctor about your treatment history—can help lower your risk of future cancers.

DOI: 10.1016/j.ijrobp.2025.07.1424

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