Photons - Radiobiological issues related to the risk of second malignancies

Non-targeted effects such as radiation-induced genomic instability, bystander or abscopal effects could also impact on the risk of SMN. Recent studies show that beside the known cellular changes, bystander effects can be manifested through increased cell proliferation, which could be a culprit for SMN development. Furthermore, new evidence on the existence of tumour-specific cancer stem cells that are long-lived and more quiescent and radioresistant than non-stem cancer cells can raise questions about their association with SMN risk.