Long term survival following treatment for primary cancer has increased significantly in the past decade. With cure comes 'survivorship'. One of the factors clearly affecting quality and length of survival is morbidity associated with treatment and the development of subsequent malignancies.This article aims to look at the risks associated with the development of second malignant neoplasms, give some meaningful figures, and provide suggestions for follow up.The balance of heightened awareness and healthy lifestyle versus relentless surveillance and ongoing patient concern is a difficult one. We hope to make our patients aware of the small but significant risk of a second malignancy, advise on any appropriate screening investigations and encourage a life long relationship with their chosen family physician to enable detection of any future malignancy.