Noelle Johnson, 42, was diagnosed with her first cancer — a soft tissue sarcoma under her right arm — in 1999 when she was 21. In 2013, her physicians found six different cancers in her breasts. In the years that followed, surgeons discovered and removed numerous masses they deemed “premalignant” from her ovary, her uterus, her leg, arm, and chest wall, aiming to get them out before they turned cancerous. Each tumor was distinct, that is, none resulted from the spread of any of the others. For Johnson, having multiple primary tumors diagnosed at an unusually young age was both scary and baffling. “It was crazy,” recalls Johnson, who lives in Windsor, Col., where she operates a day-care center in her home. “My world started to spin. It was a huge red flag.” Many people assume that when cancer shows up following an earlier tumor, it is a metastasis from the first. But this is not always the case. Multiple primary cancers can arise by themselves, and researchers in recent years have begun to unravel some of the reasons.
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