Due to advances in cancer treatment, many people with the disease are living longer, especially children with cancer. Because of this, the medical field is seeing side effects that were previously not known. A late effect of cancer is defined as a side effect occurring more than five years after treatment has ended, according to the American Society of Clinical Oncology. Some late effects may not show up for years, or even decades, after treatment has ended, according to cancer.org.
Physical Late Effects
Certain chemotherapy drugs are known to potentially cause heart problems later in life, but many late effects concerning the heart stem from radiation treatment to the chest, according to cancer.net. Late effects include inflammation of the heart muscle, congestive heart failure and heart disease. Along with cardiovascular problems, radiation to the chest and various chemotherapy drugs can also cause lung damage and difficulty breathing. Fertility is a common concern for cancer survivors, for good reason. Chemotherapy, and radiation, depending on which area is being irradiated, can cause damage to the ovaries and testes, as well as affect hormone levels, according to the American Cancer Society. The American Society of Clinical Oncology states that osteoporosis is the most common late effect of cancer treatment, with the incidence of the condition higher in cancer survivors than the general population. Second cancers are also a concern for cancer survivors, due to the exposure to radiation and certain drugs used in their treatment regimens.
Neurological Late Effects
It has been noted that children who received chemotherapy and radiation to the head have slight drops in their IQ and have learning disorders, shorter attention spans and memory difficulties. Hearing and eyesight problems have also been seen in cancer survivors. One-third of all cancer survivors, according to the American Society of Clinical Oncology, report fatigue as a side effect. Cancer-related fatigue is different than general fatigue and does not go away, even with rest. Going along with fatigue may be emotional difficulties, trouble coping, feelings of depression, difficulty living with uncertainty about one's health, and facing possible discrimination in the work force.
Recommendations
Most of the late effects now known about are gleaned from childhood cancer survivors; as they get older, it is easier to see how the cancer has affected them on a long-term scale. With 80 percent of childhood cancer patients surviving five years or more post-treatment, this is a fairly large sample. There have been guidelines established to help monitor cancer survivors for late effects, but many times, there are difficulties getting the patients to adhere to the repeated follow-up visits and tests. Some tests that are recommended for cancer survivors include yearly mammograms, regular blood tests and imaging studies such as CT scans, and regular echocardiograms to monitor any heart problems. If the patient decides to seek follow-up care from the primary care physician and not the oncology team, it is crucial that the primary care physician obtain all the treatment records, the dosages of medications given, the exact diagnosis and anything else related to treatment, so she can appropriately care for the patient.
