Parents, survivors and their primary doctors should be aware of the risks for second primary cancers.
Below are symptoms of the most common second cancers linked with a constitutional RB1 mutation and retinoblastoma treatment.
See your doctor promptly if you have any unexplained symptoms that persist for more than 1-2 weeks. If your primary doctor is unable to help, contact your long term follow up oncologist or the doctor who treated your retinoblastoma.
Osteosarcoma (bone cancer)
- Persistent pain or tenderness at the cancer site that worsens with exercise
- Reduced movement if the cancer is near a joint
- Swelling around the affected bone
- Broken bone
Soft Tissue Sarcoma
Symptoms depend on the cancer’s location, but include:
- head: painless or uncomfortable lump or a poorly fitting artificial eye
- limbs: painless or uncomfortable swelling
- lung: cough or breathlessness
- abdomen: pain, constipation, vomiting blood
- any painful or tender lump that is bigger than 5cm
Malignant Melanoma (skin cancer)
Look for changes in the size, shape or colour of a mole or freckle. Warning signs include:
- irregular shape
- uneven colour
- more than 6mm diameter (larger than the blunt end of a pencil)
- unusual skin marks that last more than a few weeks
- tingling, itching, crusting or bleeding of a mole
- something growing under a nail or a new pigmented line in a nail
Brain Tumours
Symptoms vary widely. They arise because the tumour puts pressure on the brain, or because it disrupts function of the structures where it is located.
Symptoms of increased pressure are:
- Headache: usually associated with nausea and vomiting. Pain and nausea are worst in the morning, easing throughout the day. Coughing, sneezing, leaning forward or exercise can increase the pain, and vomiting may reduce it.
- Drowsiness – sleeping or “dropping off” excessively
- Blurred vision, ‘floating objects’ and tunnel vision.
- Balance problems
- Confusion
See your doctor if any of these symptoms persist for more than a week.
Symptoms caused by location include:
- Frontal lobe: altered personality or intellect; uncoordinated gait; weakness on one side of the body; loss of smell; occasional speech impairment.
- Parietal lobe: difficulty speaking or understanding words; problems with writing; reading or simple calculation; poor coordination; numbness on one side of the body.
- Occipital lobe: loss of vision.
- Temporal lobe: Speech and memory problems; seizures that may cause a feeling of fear, familiarity (déjà vu) or strange smells.
- Cerebellum: Unsteady gait; poor articulation (speech); flickering involuntary movement of the eyes; vomiting; stiff neck.
- Brain stem: Unsteady gait; a one-sided smile; drooping eyelid; double vision; difficulty speaking and swallowing.
These symptoms may be caused by other conditions. See the doctor if individual symptoms persist for more than two weeks or if a cluster of symptoms persist for more than one week.
Acute Myeloid Leukemia and Myelodysplastic Syndrome
Symptoms of these two conditions are the same. Most occur due to damaged bone marrow. The main symptoms are:
- pale skin, fatigue and breathlessness (low red cells)
- increased infection (low white cells)
- easy bruising, bleeding gums, frequent nosebleeds (low platelets)
- A rash of tiny, flat red spots on the legs or in the mouth (petechiae)
- Aching bones (caused by too many immature cells in bone marrow)
- blue-purple bumps under the skin (leukaemia cells in the skin)
- Swollen gums (leukaemia cells in the gums).
