About 17 million cancer survivors live in the United States. Many of them are survivors of a childhood cancer.
In the last 30 years, treatments and supportive care have improved. As a result, more than 80% of children treated for cancer live 5 years or more after treatment. But they are at risk for long-term side effects, called “late effects” that are related to their prior treatments.
Late effects can develop during treatment and continue into survivorship. Or, they can develop many years after a cancer diagnosis.
It is important to know the following:
Talk with your health care team about how to screen for, prevent, or manage late effects. This is an important part of your care after cancer treatment.
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Learning problems. Some chemotherapy drugs and/or radiation to the brain may interfere with learning. The problems can range from mild to severe, and may show up during treatment, soon after treatment, or several years later. Common learning problems include problems with memory, processing speed, and multi-tasking.
Abnormal bone growth. Sometimes kids do not grow in the usual timeframe and/or stop growing much earlier than normal. This may be due to radiation treatment, chemotherapy, or a brain tumor or its treatment.
Kids may also be at risk for developing osteoporosis (bone thinning) or scoliosis (a curved spine).
Thyroid problems. The thyroid is a gland of the endocrine system that controls metabolism (chemical reactions in the body’s cells). It may be damaged by radiation to the head or neck. The result is typically hypothyroidism (when the thyroid doesn’t make enough thyroid hormone), leading to tiredness, weight gain, thinning hair, and dry skin.
Hearing loss. Chemotherapy, radiation to the brain, and even some antibiotics can lead to high-frequency hearing loss (when a person cannot hear high-pitched sounds), tinnitus (ringing in the ears), or dizziness.
Vision problems. Blurred or double vision, glaucoma, or cataracts are more likely in kids who were treated for tumors near the eye or received radiation to the brain.
Dental problems. Short dental roots, delayed teeth, or missing teeth are more common in very young children who’ve had radiation to the brain and/or chemotherapy with a drug called vincristine. All kids who have had chemo are at risk for tooth decay and gum disease.
Lung, liver, or kidney problems. Childhood cancer treatments have been linked to several types of body organ damage later in life. How serious the organ damage is depends on the type of cancer and treatment.
Heart problems. Kids who had chest radiation and/or chemo with a class of drugs called anthracycline are at higher risk for heart problems up to 20 years or longer after treatment. The severity of the problem depends on how much chemo and/or chest radiation they got and the child’s age during treatment. Family genetics, weight, and cholesterol level also play a role in in getting heart problems.
Delayed sexual development and fertility issues. Both chemotherapy and radiation can cause fertility problems. These late effects may be from damage to the endocrine system (which starts the onset of puberty) or to the sexual organs themselves.
Because of the risk, special measures may be taken before or during treatment to protect the reproductive organs. For example, doctors may shield the ovaries and testicles during radiation treatment. Teen boys and girls may be able to bank their sperm and eggs before cancer treatment. The good news is that despite these risks, many childhood cancer survivors can go on to have healthy children of their own.
Increased risk of future cancers. Childhood cancer survivors have a slightly higher risk of developing a second cancer at some point even if the original cancer doesn’t come back. Many things affect this risk, such as the type of the first cancer, the treatments given, and any genetic risks.
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Some side effects of chemotherapy only happen while you’re having treatment and disappear quickly after it’s over. But others can linger for months or years or may never completely go away. A month or two after chemo ends, however, most people assume their immune system has returned to normal. Now, new research suggests that the effects of chemotherapy can compromise part of the immune system for up to nine months after treatment, leaving patients vulnerable to infections at least when it comes to early-stage breast cancer patients who’ve been treated with a certain type of chemotherapy.
Treatments that help people beat cancer also can cause them to age prematurely and die sooner. Cancer survivors naturally age faster than others who haven’t had cancer, and are more likely to develop long-term health problems related to aging while they’re still relatively young, the study authors said.
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Chemotherapy is a medication that works throughout the whole body to attack, and hopefully kill, cancer cells. There are hundreds of different kinds of chemotherapy medications and some are used individually while others may be combined for treatment. Chemotherapy can be administered a number of ways but common ways include orally and intravenously. The chemotherapy itself stays in the body within 2 -3 days of treatment but there are short-term and long-term side effects that patients may experience. Not all patients will experience all side effects but many will experience at least a few. Drinking plenty of water before and after treatment helps your body process chemotherapy drugs and flush the excess out of your system.
A side effect of chemotherapy known as chemo brain can cause fatigue, depression, mental fog, and other forms of cognitive impairment. Cancer treatments, including many of the chemotherapy medications, can directly impact the way people feel emotionally and physically.
Late effects are side effects of cancer treatment that become apparent after your treatment has ended. Cancer survivors might experience late effects of cancer treatment years later. Chemotherapy and radiation therapy can cause long-term side effects to the brain, spinal cord, and nerves. These include: Hearing loss from high doses of chemotherapy, especially drugs like cisplatin (multiple brand names) Increased risk of stroke from high doses of radiation to the brain.
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