Long term side effects of cancer treatment
After receiving cancer treatments, not all cancer survivors experience noticeable long term side effects of cancer treatment or “late effects”. If this happens, some long-term effects, such as fatigue, may persist for months or even years after treatment is finished. Late effects, including certain illnesses such as heart disease or the onset of secondary cancer, do not appear until years after stopping treatment. These effects can be mild as well as severe.
Ask your doctor what long-term effects or late effects might affect you. The risk of experiencing such effects may vary depending on:
- the type and duration of your treatment;
- your age at the time of treatment;
- your gender;
- your general health.
How long do the side effects last?
The side effects of chemotherapy usually behave differently from patient to patient. While they will last for a relatively long time in some, they will be shorter in the blood and then in the red and white blood cells. It should be noted that these effects can appear several months or even years after treatment, depending on the ammount of the treatments and general health conditions:
1. Quick side effects (Short term side effects of cancer treatment)
Normal, healthy cells usually recover quite quickly when chemotherapy is finished. In this case, the side effects do not last long and go away with the restoration of the cells. Normal, healthy cells usually recover quite quickly when the chemotherapy treatment is finished. In this case, the side effects (vomiting, nausea, fever, bone pain and mouth pain do not last long and go away with the restoration of normal cells. Read also: Chemotherapy | Type, What to Expect (Before, During, After), Side Effects
2. Late side effects (Long term side effects of cancer treatment)
Some side effects can last for months or even years before disappearing completely in a person’s life. It is certainly rare, but not impossible for the side effects of treatment to last a lifetime. This is the case when chemotherapy causes permanent damage to the heart, lungs, kidneys and reproductive organs.
In the fight against cancer, some types of chemotherapy can also cause side effects years after stopping treatment. They can also be responsible for the development of liver cancer or lung cancer.
Radiation therapy (radiotherapy) may cause long-term changes. Your skin may be slightly darker, and pores may be larger and more noticeable. The skin may be more or less sensitive and feel thicker and firmer than it was before treatment. Radiotherapy makes tissues less stretchy. Doctors call this radiation fibrosis. How this affects you will vary depending on which part of your body was treated.
Hormone therapy may cause blood clots, hot flashes (in men as well as in women), increased risk of other cancers
menopausal symptoms, osteoporosis, sexual side effects (men and women).
Types of late effects (long term side effects of cancer treatment)
Almost all cancer treatments can cause late effects. And different treatments can cause different late effects. Below is a list of the most common late effects. Talk to your doctor about your concerns about a specific late effect.
Surgery problems
The late side effects of surgery depend on the type of cancer and where in the body you have had the surgery:
- Hodgkin lymphoma survivors, especially those diagnosed before 1988, have often had their spleen removed. The spleen is a vital organ for the immune system. Removing it is linked to a higher risk of infections.
- Survivors of bone and soft tissue cancer may have lost part or all of a limb. It can cause physical and emotional effects. One example is the pain of phantom limbs. It makes you feel pain in the limb that has been removed, even though it is no longer there. Rehabilitation can help people cope with the physical changes in treatment.
- People who have had radiation therapy or surgery to remove lymph nodes may develop lymphedema. Lymph nodes are tiny, bean-shaped organs that help fight infection. Lymphedema occurs when lymph fluid builds up and causes swelling and pain.
- People who have had certain pelvic or abdominal surgeries may not have children. This is called infertility.
Heart problems
Chemotherapy and radiation therapy to the chest can cause heart problems. Some survivors may have a higher risk. This includes those who:
- Received treatment for Hodgkin lymphoma as a child
- Are 65 years old and over
- Received higher doses of chemotherapy
- Received certain drugs, such as trastuzumab (Herceptin, Ogivri) and doxorubicin (Adriamycin, Doxil)
Here is a list of common heart conditions. Talk to your doctor right away if you get any of these symptoms:
Congestive heart failure (CHF) weakens the heart muscle. Symptoms include shortness of breath, dizziness, and swelling of the hands or feet.
Coronary artery disease is a type of heart disease. It is more common in those who have received high doses of radiation therapy to the chest. Symptoms include chest pain and shortness of breath.
Arrhythmia is an irregular heartbeat. Symptoms include dizziness, chest pain, and shortness of breath.
Examples of drugs that can cause heart problems:
- Trastuzumab
- Doxorubicin
- Daunorubicin (Cerubidine)
- Epirubicin (Ellence)
- Cyclophosphamide (Genoxal, Mitoxan)
- Osemertinib (Tagrisso)
Ask your doctor if the treatments you are receiving may affect your heart. He or she can check your heart function and watch for damage during and after treatment. Your doctor may use a test called an echocardiogram, also called an echo. Other heart tests may include a physical exam, an electrocardiogram (ECG or ECG), and a multigated acquisition scan (MUGA).
There are many different chemotherapy drugs and they all have different side effects. Please ask your doctor or specialist nurse about the drugs you are having if you are worried about long term effects from your treatment.
Hypertension (it is also called high blood pressure)
Or it may be a separate symptom. If you have high blood pressure, your doctor may monitor it more closely during cancer treatment. Accelerated hypertension is when blood pressure rises suddenly and rapidly. It often causes organ damage. It is therefore vital to get medical help immediately.
Some anti-cancer drugs can cause high blood pressure. Examples of these drugs include:
- Bevacizumab (Avastin, Mvasi)
- Sorafenib (Nexavar)
- Sunitinib (Sutent)
The risk of high blood pressure decreases once a person stops taking these medicines. But the long-term effects are not known. Survivors at increased risk for high blood pressure should work with their healthcare team to reduce this risk. This can include blood pressure tests, weight loss, reduced salt intake, medication and physical activity.
Lung problems
Chemotherapy and radiation therapy to the chest can damage the lungs. Cancer survivors who have received both chemotherapy and radiation therapy may have a higher risk of lung damage. People who have had lung disease and the elderly may have more lung problems.
Drugs that can damage the lungs include:
- Bleomycin (Blexane)
- Carmustine (Becenum, BiCNU, Carmubris)
- Methotrexate (several brand names)
Late effects on the lungs can include:
- A change in how the lungs work
- Thickening of the lining of the lungs
- Inflammation of the lungs
- Difficulty in breathing
Problems with the endocrine system (made up of all the organs that have the capacity to release hormones into the blood)
Some types of cancer treatment can affect the endocrine system. This system includes the glands and other organs that make hormones and make eggs or sperm. Cancer survivors at risk for hormonal changes from treatment need regular blood tests to measure hormone levels.
- Menopause. Many cancer treatments can cause symptoms of menopause in women. These treatments include:
- Surgery to remove a woman’s ovaries (oophorectomy)
- Chemotherapy
- Hormonal therapy
- Radiation therapy to the pelvic area Symptoms of menopause caused by cancer treatment may be worse than symptoms of natural menopause. This is because the decrease in hormones occurs more quickly. Symptoms include:
- Changes in mood or sexual desire
- Hot flashes
- Osteoporosis
Bladder Control Problems. Women on hormone therapy who have not gone through menopause may have lighter and fewer periods. Menstruation may stop completely for other women. After treatment, periods may return for some younger women. But women over 40 are less likely to see them return. Sometimes cancer treatment causes menopause earlier than normal. It can also cause the onset of menopause.
- Hormonal problems for men. Some treatments can cause menopause-like symptoms in men. These include hormone therapy for prostate cancer or surgery to remove the testicles. Symptoms may include:
- Change in sexual desire
- Hot flashes
- Osteoporosis
- Infertility. Treatments that affect the reproductive organs or the endocrine system increase the risk of infertility. Infertility means not being able to get pregnant or father a child. Sometimes infertility from cancer treatment lasts a short time. But sometimes it’s permanent.
- Hormonal problems associated with radiation therapy to the head and neck. Radiation therapy to the head and neck can lower hormone levels. It can also cause changes in the thyroid gland.
Bone, joint and soft tissue problems
Chemotherapy, steroid drugs, or hormone therapy can cause bone thinning, called osteoporosis or joint pain. Immunotherapy can cause joint or muscle problems. These are rheumatological problems. People who are not physically active may have a higher risk of these conditions.
Cancer survivors can reduce their risk of osteoporosis in these ways:
- Avoid tobacco products
- Eat foods rich in calcium and vitamin D
- Become physically active
- Limit the amount of alcohol they drink
Brain, spinal cord and nervous problems
Chemotherapy and radiation therapy can cause long-term side effects on the brain, spinal cord, and nerves. These include:
- Hearing loss due to high doses of chemotherapy, especially medicines like cisplatin (several brand names)
- Increased risk of stroke due to high doses of radiation to the brain
- Side effects of the nervous system, including damage to nerves outside the brain and spinal cord, called peripheral neuropathies
- Cancer survivors should have regular physical exams and hearing tests after treatment to check for these effects.
Learning, memory and attention difficulties. High dose chemotherapy and radiation therapy to the head and other parts of the body can cause cognitive problems in adults and children. Cognitive problems arise when a person has difficulty processing information. Talk to your doctor if you have any of these problems.
Chemotherapy Drugs Combinations | Chemo Medications: Understanding Medications for Cancer Treatment
Dental and oral health and vision problems
Cancer survivors can have dental and oral health and vision problems, depending on the treatments they have received:
- Chemotherapy can affect tooth enamel and increase the risk of long-term dental problems.
- High doses of radiation therapy to the head and neck area can affect the development of teeth. It can also cause gum disease and reduce the production of saliva, causing a dry mouth.
- Steroid drugs can increase the risk of eye problems. This includes clouding of the eye that affects vision, called a cataract.
To watch for future problems, survivors should schedule regular appointments with a dentist and ophthalmologist. An ophthalmologist is a doctor who specializes in the treatment of eye conditions.
Read also: Eye Diseases and Common Eye Problems (List of eye diseases and disorders)
Digestion problems
Chemotherapy, radiation therapy, and surgery can affect the way a person digests food. Surgery or radiation therapy to the abdominal area can cause tissue scarring, long-term pain, and bowel problems. Some survivors may have chronic diarrhea which reduces the body’s ability to absorb nutrients.
A Registered Dietitian (RD) can help people with digestion issues get enough nutrients. It may also be helpful to see a doctor who specializes in the digestive tract, called a gastroenterologist.
Emotional difficulties
Cancer survivors often have a variety of positive and negative emotions:
- Relief
- A feeling of gratitude for being alive
- Fear of recurrence
- Anger
- Guilt
- Depression
- Anxiety
- Feeling lonely
Cancer survivors, caregivers, family and friends can also suffer from post-traumatic stress disorder. This is an anxiety disorder. It can develop after going through a very scary or life-threatening event, such as cancer diagnosis and treatment.
Everyone’s post-treatment experience is different. For example, some survivors struggle with the negative emotional effects of cancer. Others say they have a positive and renewed outlook on life because of cancer.
Secondary cancers
It may be a new primary cancer. It can develop as a late effect of previous cancer treatments, such as chemotherapy and radiation therapy. Or it could be the original cancer that has spread to other parts of the body where it started.
Chemotherapy and radiation therapy can also damage stem cells in the bone marrow. This increases the risk of acute leukemia or myelodysplasia. Myelodysplasia is cancer of the blood where normal parts of the blood are not made or are abnormal. Talk to your doctor about any new symptoms or side effects you experience.
Tired (fatigue)
Fatigue is a constant feeling of physical, emotional, or mental fatigue. This is the most common side effect of cancer treatment. Some cancer survivors experience fatigue for months or even years after completing treatment.
Note: Other Long term side effects of cancer treatment can occur. For more details on specific medications, please consult your doctor or oncologist.
List of all Cancers
The word “cancer” is a generic term for a large group of diseases that can affect any part of the body. We also speak of malignant tumors or neoplasms. One of the hallmarks of cancer is the rapid multiplication of abnormal growing cells, which can invade nearby parts of the body and then migrate to other organs. This is called metastasis, which is the main cause of death from cancer. Types of cancer (in alphabetical order of the area concerned):
Information: Cleverly Smart is not a substitute for a doctor. Always consult a doctor to treat your health condition.
Sources: PinterPandai, Cancer Research UK, American Cancer Society, National Cancer Instituteat the National Institutes of Health, Medical News Today, Macmillan Cancer Support
Photo credit: Firmanamff / Pixabay