CML Hub__>__CML & Secondary Cancers

CML & Secondary Cancers

__7 February 2022

Thanks to modern treatments, Chronic Myeloid Leukaemia (CML) is usually a manageable, long-term condition, that you live with.[AND19]

But unfortunately, being diagnosed with cancer doesn’t mean you won’t get a new, unrelated type of cancer in the future. In fact, there is some evidence to suggest that people living with CML may be more at risk of developing another cancer than the general population. When this happens, it’s often referred to as a ‘second primary cancer’ or a ‘secondary malignancy’.[GUG17,GUN15,ACS1,KUM18]

We can’t predict who might develop a second cancer,[KUM18] so it’s important to understand the risks, and to remain proactive about your health.

Why might I have a higher risk of developing a second cancer?

The truth is, nobody knows. Many factors could play a role, for example: [REB10]

  • You may have a higher risk of developing cancer due to your genes or family history
  • You may have been exposed to a substance (tobacco smoke, for example) that plays a role in both CML and other types of cancer
  • It might be that second cancers are more likely to be picked up, due to increased medical monitoring of people living with cancer, in comparison to the general population

What’s reassuring is that the risk of developing a second primary cancer is not thought to be a related to medications called TKIs (tyrosine kinase inhibitors), which are the standard treatment for CML. So, if you’re taking a TKI, it’s essential that you continue the treatment.[ACS2,GUN15,KUM18]

What can I do to lower my risk?

Making positive lifestyle changes can help maintain good health: [ACS1]

  • If you are a smoker with CML, it’s really important to try to quit (find out more about why here)
  • Try to maintain a healthy weight
  • Follow a healthy diet that includes plenty of fruits, vegetables, and whole grains (Why not check out our quick, easy and healthy meal suggestions?)
  • Limit how much alcohol you drink
  • Keep active with regular exercise

Be proactive with your physical health

Most people with CML see their healthcare team often. Probably the most important thing you can do for your health is to make sure you attend all your appointments. Talk to your healthcare team about your risks and what you can do to reduce them. It might be worth writing a list of questions, such as: [ACS1]

  • What can be done to help prevent or detect second cancers?
  • What should I be looking out for?
  • Are there any other additional tests I need?

See your doctor right away if you notice any of the following: [ACS3]

  • A new lump or growth
  • New or unusual prolonged pain
  • Losing weight without trying
  • A cough that doesn’t go away
  • Blood in your stools (poo) or urine

Check out our guide on talking to your doctor.


Be proactive with your mental health, too

Whilst it’s important to be proactive, it’s easy to spend  more time than you’d like worrying about your health. And that’s understandable— living with CML isn’t easy. If you’re feeling particularly anxious or overwhelmed, talk to your healthcare team, as they might be able to recommend ways to cope.

Rest assured that most people living with CML will not develop a second cancer.[GUG17, GUG15,] So if you do develop a worrying symptom, remind yourself that it’s probably not anything to worry about. But it’s best to get checked out.



[ACS1] American Cancer Society. Second Cancers After Chronic Myeloid Leukemia. Available at: Accessed November 2021

[ACS2] American Cancer Society. Targeted Therapies for Chronic Myeloid Leukemia. Available at: Accessed November 2021

[ACS3] American Cancer Society. Can I Do Anything to Prevent Cancer Recurrence? Available at: . Accessed November 2021

[AND19] Andrews, C. N., et al. The true value of second-generation TKIs as first-line therapy in

chronic myeloid leukaemia. The Lancet: Haematology. 2019;6(8):385-386.

[GUG17] Gugliotta, G., et al. Incidence of second primary malignancies and related mortality in patients with imatinib-treated chronic myeloid leukemia. Haematologica. 2017;102(9):1530-1536.

[GUN15] Gunnarsson, N., et al. Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era. British Journal of Haematology. 2015;169(5):683-688.

[KUM18] Kumar, V., et al. An observational study on risk of secondary cancers in chronic myeloid leukemia patients in the TKI era in the United States. Peer J. 2018;12(6):4342.