What Are Late Effects seen after Cancer Treatment?
Most children with cancer get better with the treatment available nowadays. Medicine has been very successful over the last few decades, and we’ve seen excellent survival rates. However, cancer survivors may develop long-term side effects from the treatment they’ve received. These are called late effects. With early diagnosis and management, doctors can treat most late effects immediately. Therefore, regular follow up is very important.
What Causes Late Effects?
The usual cause of late effects is the treatment itself – chemotherapy and radiation – rather than cancer. Further research is required to understand why late effects happen. Scientists believe that damage to children’s cells at critical points in the development cycle leads to late effects. The late effects seen in survivors of childhood cancer depend on:
- The type of cancer your child had
- The cancer site in their body
- Dosage and type of chemotherapy and radiation treatment
- What the age is and how healthy the child was before cancer diagnosis
What Are the Commonly Seen Late Effects of Cancer?
Some commonly seen late effects are:
Learning problems- Some chemotherapy drugs and/or radiation treatment may cause learning problems ranging from mild to severe. Typical learning problems include memory issues, problems with the brain processing information and multi-tasking.
Abnormal growth – Sometimes, survivors of childhood cancer display abnormal growth patterns. They do not grow sufficiently in the usual timeframe and/or show stunted growth. This could be because of the radiation treatment, especially to the brain, leading to a deficiency of the growth hormones. In addition, sometimes prolonged dosage of steroids can cause osteoporosis (bone thinning).
Thyroid problems- The thyroid is a gland of the hormone system that handles normal body functions, growth and development. Radiation to the head or neck may damage it. Such children typically develop hypothyroidism (when the thyroid doesn’t make enough thyroid hormone) later on in life, leading to tiredness, weight gain, thinning hair, and dry skin.
Hearing loss- Chemotherapy like Cisplatin, radiation to the brain, and even some antibiotics can lead to hearing loss.
Vision problems- Blurred or double vision, glaucoma, or cataracts are more likely in kids who received chemotherapy or radiation in the brain.
Dental problems- Short dental roots, delayed teeth eruption, or missing teeth are frequently seen in young children who’ve had chemotherapy or radiation to the brain. In addition, all kids who have undergone chemotherapy are at risk for tooth decay and/or gum disease.
Lung, liver, or kidney problems- Childhood cancer treatments have been linked to body organ damage later in life. How severe the organ damage depends on the dose of chemotherapy given.
Heart problems. Kids who have had chest radiation and/or chemo with a class of anthracycline drugs are at higher risk for heart problems. The seriousness of the complications depends on how much chemo and/or chest radiation they got and the child’s age during treatment.
Delayed sexual development and fertility issues- Both chemotherapy and radiation can lead to fertility problems. Late effects may result from damage to the sexual organs or the hormonal system.
Because of this risk, you should take special measures before or during cancer treatment to safeguard the reproductive organs. For example, doctors can protect the ovaries and testicles with a shield during radiation treatment. In addition, teen boys and girls may save their eggs and sperm in a fertility clinic before cancer treatment. Despite these risks, the wonderful news is that many childhood cancer survivors have healthy children of their own later in life.
Increased risk of future cancers- Childhood cancer survivors have a marginally higher risk of developing second cancer — even if the primary cancer doesn’t return. Many factors may contribute to this, such as the first cancer, the treatments given, and any genetic risks they may have.
What can parents do once the treatment of cancer has been completed?
After the treatment ends, ask the doctor for a “full treatment summary.” This includes all the information related to your child’s cancer diagnosis, treatment, and follow-up care. Follow-up care may include regular screenings like blood tests, hearing tests, vision tests, and heart tests (echocardiograms).
When your child is named cancer-free, you may be tempted to stay away from doctors and hospitals, but you need to understand that your child needs to be monitored for years to come. Moreover, if doctors detect late effects early on, they can be managed much better.
Your child must adhere to their follow-up care schedule. Even after finishing the planned follow up, it is better to visit your doctor for regular check-ups now and then, even if there are no symptoms or signs of late effects.
