In clinical practice, physicians occasionally encounter a special type of case commonly referred to as “spousal cancer.” These cancers are not contagious between spouses. Rather, they are believed to result from long-term exposure to shared environmental and lifestyle factors - such as living in the same household, having similar dietary habits and daily routines - combined with advancing age and insufficient cancer screening. In this case, the 71-year-old husband was diagnosed with two primary malignancies: squamous cell carcinoma of the lung and sigmoid colon adenocarcinoma, while his 68-year-old wife was diagnosed with invasive ductal carcinoma of the breast. After both noticed abnormalities in their health and sought medical care at multiple institutions, they eventually came to our hospital together to receive individualized, standardized treatment. Following stage-specific targeted therapy, both patients experienced gradual relief of their symptoms and steady improvement in both physical and emotional well-being. Their experience also serves as an important reminder to middle-aged and elderly families of the value of scientific cancer prevention and timely, evidence-based medical care.

1. Both Spouses Were Diagnosed with Cancer and Ultimately Received Standardized Treatment at the Same Hospital

① Husband: 71 years old — Squamous Cell Carcinoma of the Lung + Sigmoid Colon Adenocarcinoma (Multiple Primary Malignancies)

For many years, the patient had experienced recurrent cough with sputum production and shortness of breath, symptoms that had persistently affected his sleep. In early November 2025, he visited a local hospital because of abdominal discomfort. CT examination revealed a suspicious malignant lesion of the rectum, and treatment was initiated accordingly. On November 21, 2025, PET-CT examination confirmed carcinoma at the rectosigmoid junction together with a primary carcinoma of the right lung. The lesions were diagnosed as two independent primary malignancies, with metastatic disease excluded. Subsequent biopsy confirmed that the intestinal lesion was a moderately differentiated adenocarcinoma, whereas the pulmonary lesion was squamous cell carcinoma. On November 28, the patient underwent radical resection for rectal cancer. However, no postoperative consolidation antitumor therapy was administered. Following surgery, his cough, chest tightness, and discomfort caused by airway compression continued to worsen. In addition, because the pulmonary lesion was located deep within the lung and in close proximity to the trachea, the risk of disease progression remained high. After learning extensively about our hospital's well-established multidisciplinary team (MDT) approach, the patient's family accompanied him to our hospital for further treatment. After comprehensive evaluation upon admission, his postoperative intestinal recovery was found to be stable. Compared with the intestinal lesion, however, the pulmonary tumor required priority intervention. Following a thorough MDT assessment that took into account the patient's advanced age, overall physical condition, and tumor characteristics, an individualized treatment strategy was established. The treatment plan prioritized management of the lung malignancy while maintaining long-term surveillance of postoperative intestinal recovery. A comprehensive one-stop treatment program was tailored specifically for the patient, consisting of bronchial arterial infusion chemotherapy combined with embolization, deep regional hyperthermia, curative-intent TrueBeam radiotherapy for the pulmonary lesion, concurrent chemotherapy to enhance radiosensitivity, and combined immunotherapy. Through the synergistic effects of multiple treatment modalities, the team aimed to achieve comprehensive disease control while reducing the risk of tumor recurrence and progression.

Figure 1：Bedside rounds conducted prior to interventional treatment

Figure 2：Left: Before treatment; Right: After treatment

To date, the patient has completed four sessions of bronchial arterial infusion chemotherapy combined with embolization. Follow-up chest CT examinations have demonstrated a continuous reduction in the size of the pulmonary lesion. Long-standing symptoms, including cough, sputum production, nocturnal chest tightness, and shortness of breath, have been significantly relieved, with a marked improvement in the patient's sleep quality. The remaining treatment sessions will be completed as planned to achieve comprehensive control of both the pulmonary and intestinal lesions.

② Wife: 68 years old — Invasive Ductal Carcinoma of the Breast

During a routine health examination in November 2025, a BI-RADS 4B lesion was detected in the patient's right breast. Subsequent core needle biopsy confirmed invasive ductal carcinoma. Immunohistochemical analysis demonstrated strong ER positivity, PR negativity, and HER2 negativity.
On December 8, 2025, the patient underwent breast-conserving radical surgery of the right breast with axillary lymph node dissection at another hospital. Postoperative pathology confirmed Stage II disease (pT2N0M0), with no lymphovascular or perineural invasion and no lymph node metastasis. No postoperative adjuvant antitumor therapy was administered.
To further assess the risk of recurrence after surgery, the patient and her husband sought a second opinion at our hospital after learning about our well-established multidisciplinary team (MDT) approach. Contrast-enhanced CT of the chest and abdomen demonstrated an extensive area of soft tissue density at the surgical site in the right breast, together with right axillary fluid collection and small lymph nodes. Considering the 2.5 cm primary tumor, comprehensive specialist evaluation indicated a relatively high risk of postoperative recurrence. Following multidisciplinary discussion, our oncology MDT recommended postoperative adjuvant chemoradiotherapy. After thorough consultation between the medical team and the patient, radiotherapy was prioritized, with systemic therapy scheduled to follow.
Beginning on January 17, 2026, the patient underwent treatment using our hospital's Ethos adaptive precision radiotherapy system, completing 15 treatment sessions. The entire course of radiotherapy was successfully completed on February 11. A follow-up PET-CT performed two months after radiotherapy revealed no evidence of suspected recurrence or metastatic disease. The patient subsequently began long-term maintenance endocrine therapy at home. At present, the surgical incision has healed well, she has no physical discomfort, is fully independent in her daily activities, and her disease remains clinically stable.

2. Common Factors Associated with “Spousal Cancer”: Early Warning Signs That Are Easily Overlooked

The simultaneous diagnosis of cancer in this elderly couple represents a case of acquired “spousal cancer”, rather than one related to hereditary predisposition or disease transmission. Such cases are most commonly associated with long-term shared living conditions. Spouses typically share the same household, similar dietary habits and daily routines, while prolonged exposure to factors such as cooking fumes, secondhand smoke, and high-fat diets may gradually damage the body's organs. In addition, people over the age of 65 are at higher risk of developing cancer and are more likely to develop multiple primary malignancies. Another common problem is the misconception that routine health examinations alone are sufficient, with many people undergoing only basic check-ups while neglecting dedicated cancer screening.
Early-stage breast cancer is often highly insidious. In most cases, it presents only as a painless breast lump or mild fullness in the axilla, without obvious pain, making it easy to mistake for benign breast hyperplasia and causing patients to lower their guard.
Gastrointestinal malignancies commonly present with intermittent abdominal pain, changes in bowel habits, unexplained fatigue, and weight loss, symptoms that closely resemble those of gastroenteritis. Centrally located lung tumors, on the other hand, rarely present with hemoptysis or severe coughing. Instead, they often manifest only as nocturnal chest tightness, sputum production, and shortness of breath, making them highly insidious and easily overlooked.

3. Our Clinical Advantages: Individualized MDT Care That Balances Effective Treatment with Holistic Patient Care

In this case, the wife was diagnosed with a single primary breast cancer, while the husband had multiple primary malignancies. Their conditions required entirely different treatment strategies and involved considerable therapeutic complexity. Leveraging our comprehensive oncology platform, our hospital implemented scientific, multidisciplinary care throughout the entire course of treatment:

Figure 3：Patient thank-you letter and group photo

① One-Stop MDT Consultation: Specialists from medical oncology, radiation oncology, interventional oncology, imaging, and pathology worked together through a multidisciplinary consultation, moving beyond the limitations of single-department decision-making. Taking into account the patients' previous surgeries performed overseas, advanced age, and tumor characteristics, individualized treatment plans were developed. The wife received Ethos adaptive precision radiotherapy, maximizing protection of the surrounding healthy breast tissue. The husband underwent TrueBeam radiotherapy combined with minimally invasive bronchial arterial interventional therapy and immunotherapy, avoiding high-risk repeat surgery while minimizing treatment-related trauma.
② Integrated Humanistic Care: In parallel with medical treatment, dedicated psychological support was provided to help alleviate the anxiety and emotional distress associated with both spouses being diagnosed with cancer. Clinical nutrition specialists also developed individualized dietary plans based on tumor metabolism and postoperative gastrointestinal function, helping improve treatment tolerance in this elderly couple.
③ Coordinated Patient-Centered Services: The treatment schedules and follow-up visits for both spouses were coordinated to streamline the overall care process. Dedicated follow-up records were established for each patient, while designated care coordinators provided guidance on home medications and the management of treatment-related adverse effects, reducing the burden of repeated hospital visits and family caregiving.