Fw: managing late effects of cancer treatment

December 24, 2007

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Cancer survivors: Managing late effects of cancer treatment

Learn about late and long-term effects of cancer treatment so that you can take more control of your health as a cancer survivor.

Your cancer treatment is over, but your risk of side effects goes on. You might be surprised to know that side effects can continue after your cancer treatment or even develop several years later. Some cancer survivors wonder why they weren't told about the possibility of late effects before they began treatment.

The fact is that not much is known about late side effects of cancer treatment. While the lack of information can be frustrating for cancer survivors, don't feel completely helpless. Find out all you can about late effects of cancer treatment and use this information to take control of your health.

What are late effects of cancer treatment?

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 a few months after treatment is completed or years later.

It isn't clear why these late effects are delayed. Some doctors believe that late effects simply weren't noticed during and immediately after your treatment, though the damage may have been there all along. It could be that your body was compensating for the damage caused by cancer treatment and is no longer able to do that, revealing these late effects.

In contrast with late effects, side effects that start during your cancer treatment and linger for months or years after are called long-term side effects. Long-term side effects usually are different from late side effects. For example, nerve damage (peripheral neuropathy) is common during some types of chemotherapy and may begin during treatment and linger for months or even years after cancer treatment is completed. Most long-term effects lessen or completely resolve with time.

Some cancer survivors wonder why they weren't told about the possibility of long-term or late side effects before they began treatment. Sometimes cancer survivors were told, but with so much to remember and go through when you're first diagnosed and beginning treatment, it's easy to forget or not absorb all the information. Sometimes your doctor doesn't discuss late side effects because it's impossible to predict every single side effect, early or late, that some treatments have. It's also possible that the late effects of your treatment weren't known at the time you began treatment.

What cancer treatments cause late effects?

Late effects of cancer treatment can come from any of the three main types of cancer treatment: chemotherapy, radiation and surgery. As newer types of cancer treatment are developed, doctors may find that these treatments also cause late effects in cancer survivors.

In general, chemotherapy tends to cause more long-term side effects than late side effects in cancer survivors, though the late effects chemotherapy causes can be serious. Radiation usually causes more late effects in cancer survivors, though it can also cause long-term effects. If you have a combination of treatments, you're more likely to experience late effects.

Treatment

Long-term side effects

Late side effects

Chemotherapy

FatigueMenopausal symptomsNeuropathyChemobrainHeart failureKidney failureInfertilityLiver problems

CataractsInfertilityLiver problemsLung diseaseOsteoporosisReduced lung capacitySecond primary cancers

Radiation therapy

FatigueSkin sensitivity

CataractsCavities and tooth decayHeart problemsHypothyroidismInfertilityLung diseaseIntestinal problemsMemory problemsSecond primary cancers

Surgery

ScarsChronic pain

Lymphedema

Keep in mind that not everyone who has cancer treatment gets each of the long-term or late side effects, and some people might not experience any aftereffects of treatment. Different chemotherapy drugs cause different late effects. So if you didn't take the chemotherapy drugs that can cause infertility, then you aren't believed to be at risk of that particular late effect. Radiation and surgery will only affect the area of the body they're used to treat. So if you had radiation to a part of your body other than your head or neck, then you won't be at risk of cavities and tooth decay as a result of your radiation therapy.

MORE ON THIS TOPIC

Chemotherapy: Drug treatment uses chemicals to kill cancer cells Radiation therapy for cancer: What to expect during treatment Cancer surgery: Physically removing cancer

What late effects might people who were treated for childhood cancers experience?

If you underwent cancer treatment as a child, you may be at risk of many of the same late side effects of treatment as people who were adults during their cancer treatments. But you may also be at risk of additional late side effects. That's because children's bones, tissues and organs are growing rapidly during treatment, so cancer treatment can interfere during this critical time of growth.

As with adult cancer survivors, late side effects in childhood cancer survivors will vary depending on the type of cancer and types of treatment. Additionally, the age at which you were treated may also determine what late side effects, if any, you might be at risk of. Some late side effects experienced by childhood cancer survivors include:

Heart problems, including an increased risk of heart attacks Blood vessel problems, including an increased risk of stroke Lung problems, which can cause difficulty breathing Liver problems Kidney problems Bone problems, such as bone thinning (osteoporosis) and curvature of the spine (scoliosis) Short stature, caused by slow bone growth Abnormal bone growth or arrested bone growth where radiation therapy is given Obesity Infertility Memory problems and learning disabilities Vision loss Hearing loss Increased risk of future cancers

If you were treated for cancer many years ago, you may assume any health problems you have are related to aging, not past cancer treatments. Tell your doctor what you know about your childhood cancer treatments. If your parents or other family members have records of your treatment, provide those for your doctor.

What signs and symptoms might signal that you're experiencing late effects of cancer treatment?

Talk to your doctor about the late effects of your particular treatment. In some cases your doctor will know what effects you're at risk of. But remember that the late effects of many treatments still aren't known.

Your doctor might be able to help you understand what signs and symptoms are clues that you're experiencing certain late effects of your cancer treatment. Your doctor might also screen you for late effects of treatment when you come in for follow-up appointments after your cancer treatment is completed.

Report to your doctor any signs or symptoms that bother you. It's best to have them checked out so that, at the very least, you don't spend a lot of time worrying about what could be wrong. And catching late effects early gives you the best chance at treating them.

If you were treated for cancer many years ago or are no longer seeing a cancer specialist for checkups, talk to your primary care doctor about late effects. If you think you might be experiencing late effects or your doctor isn't sure what late effects to watch for, ask for a referral to a cancer specialist.

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