Abstract

Patients with malignant tumours have a prevalence of 2-17% for multiple primary cancers, which means that during their lifetime they may be diagnosed with more than one primary cancer. Early age at the first diagnosis, genetic mutations and previous treatment with chemo- or radiation therapy may all contribute to a higher chance of cancer-morbidity. In this article we present a case of multiple primary cancers and describe the background of the disease. In addition, we will give an insight into Estonian epidemiological situation based on anonymous data from the Estonian Cancer Registry.
This case presents a 75-year-old female patient who has been diagnosed with 5 different malignant tumours: invasive ductal carcinoma of the breast, anal canal and rectum adenocarcinoma, non-invasive bladder cancer, basalioma and adenocarcinoma of the lung. The patient has also had many recurrencies of bladder and breast cancer with metastasis. She has been operated and treated with many kinds of anticancer therapies, including chemo-, hormonal and radiotherapy. In this case, we have pointed out age at first diagnosis and previous anticancer therapy as the most important risk factors. Genetic testing has not been carried out, but should be considered valuable in this context. This case demonstrates a rare, real, example of a multiple primary cancer patient and their complex treatment approach. Further research on influencing factors that would make it possible to predict both the development of multiple cancers and more effective treatment in patients with multiple primary cancers is necessary.