Treatment for childhood cancer - long-term risks
Today's cancer treatments help cure many children of cancer. These treatments also may cause health problems later on. These are called "late effects."
Late effects are treatment side effects that appear several months or years after treatment for cancer. Late effects can impact one or more areas of the body. Effects can be mild to severe. Examples include learning, vision, joint, or teeth problems.
Whether your child will have late effects depend on the type of cancer and the treatments your child has. Being aware of your child's risk of long-term health problems can help you follow-up with health care providers and detect any problems early.
Childhood cancer - late effects
What Causes Late Effects
Some cancer treatments damage healthy cells. The damage is not seen during treatment, but as the child's body grows, changes in cell growth or function appear.
The medicines used for chemotherapy and the high-energy rays used in radiation therapy can harm healthy cells. This damage can change or delay the way cells grow. Radiation therapy has a more direct effect on long-term growth than chemotherapy.
When cancer surgery is performed, it may cause changes in the growth or function of an organ.
Your child's health care team will come up with a treatment plan to avoid harming healthy cells as much as possible.
Every child is unique. The risk of getting a late effect depends on many factors such as:
Types of Late Effects
There are many types of late effects depending on where the cancer was and what types of treatments were done. Many of the effects can be managed. The following are examples of some late effects based on body parts affected.
Other late effects may include:
Most of the effects above are physical. There may be long-term emotional effects as well. Coping with health problems, extra medical visits, or the worries that come with cancer can be a lifelong challenge.
Preventing Health Problems
Many late effects cannot be prevented, but others can be managed or treated.
There are some things your child can do to help prevent other health problems and detect problems early such as:
Watching for late effects will be a key part of your child's care for many years. The Children's Oncology Group (COG) creates guidelines for long-term follow-up in children and adolescents who have had cancer. Ask your child's provider about the guidelines. Follow these general steps:
Regular follow-up and care gives your child the best chance of recovery and good health.
American Cancer Society website. Late effects of childhood cancer treatment. www.cancer.org/treatment/childrenandcancer/whenyourchildhascancer/children-diagnosed-with-cancer-late-effects-of-cancer-treatment. Updated September 18, 2017. Accessed August 22, 2018.
National Cancer Institute website. Children with cancer: A guide for parents. www.cancer.gov/publications/patient-education/children-with-cancer.pdf. Updated September 2015. Accessed August 22, 2018.
National Cancer Institute website. Late effects of treatment for childhood cancer (PDQ) - health professional version. www.cancer.gov/types/childhood-cancers/late-effects-hp-pdq#section/all. Updated July 6, 2018. Accessed August 22, 2018.
Vrooman L, Diller L, Kenney LB. Childhood cancer survivorship. In: Orkin SH, Fisher DE, Ginsburg D, Look AT, Lux SE, Nathan DG, eds. Nathan and Oski's Hematology and Oncology of Infancy and Childhood. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 72.
Review Date: 7/26/2018
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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