Long Term Side Effects of Chemotherapy

Updated on 18 August 2022

With the advancement in treatment modalities, there is an improvement in the treatment and cure rates of cancer patients. As a result, more children with cancer are getting cured and growing up as cancer survivors. Cancer survivorship has its own challenges, as cancer treatment can have many side effects. While there are many side effects that occur during treatment, the late effects of cancer treatment may appear many years later.

Late Effects of Cancer Therapy on Various Organs

  • Heart-related problems

Chemotherapy agents can damage the heart and increase the risk of coronary artery disease, stroke and heart failure. Those patients who receive a class of chemotherapy agents called anthracyclines, and those who receive radiation therapy to the chest are more at risk for developing heart disease in future.

Congestive heart failure is the weakening of the heart muscle. Symptoms include shortness of breath, dizziness, and swollen hands or feet. Coronary artery disease is a type of heart disease. It is more common in those who had high doses of radiation therapy to the chest. Symptoms include chest pain and shortness of breath.

  • Lung problems

Many drugs as well as radiation to the chest can cause damage to the lungs, due to which there can be restrictions on lung capacity. Symptoms include wheezing, coughing, and difficulty in breathing.

  • Hormone production

Radiation to the chest or neck can lower thyroid hormone production, and radiation to the head can cause a decrease in pituitary gland function, leading to growth retardation, delayed puberty etc.

  • Hearing impairment

Children with cancer are often treated with drugs such as cisplatin which cause impairment in hearing. Children under 5 years of age are especially more prone to hearing loss due to these medicines.

  • Infertility

Some chemotherapy agents like cyclophosphamide can damage the reproductive organs. Radiation to the brain can cause a decrease in hormone levels in both males and females. Radiation given directly to the abdomen or genitals further damages the reproductive organs. All these problems can cause low hormone levels and even permanent infertility, which is the inability to have children, in both males and females. Sometimes prior to such treatment, it is possible to preserve ova or sperms from the patient, which can be later used for conception.

  • Brain, spinal cord and nerve-related problems

Children with cancer who are treated with high doses of radiation to the brain are at increased risk of stroke. Chemotherapy and high-dose radiation therapy to the head may cause cognitive problems in adults and children. Since the brain is in the developing stage in younger children, they are more at risk for developing cognitive problems. Cognitive problems occur when a person has trouble processing information. There can be low IQ, poor attention, inability to concentrate, poor memory etc. For this reason, radiation is avoided in very young children.

Many chemotherapy agents and radiation to the spine can damage the nerves outside the brain and spinal cord called peripheral neuropathy. Symptoms include tingling, numbness, and poor motor skills in the hands and legs. There can also occur urinary retention, or urinary or bowel incontinence due to nerve damage.

  • Kidney problems

Almost all the chemotherapy agents get excreted from the body through the kidneys, many of which cause damage to the kidneys. Sometimes children can have tumours in the kidney itself, and the removal of one kidney can put the other at high risk. Radiation to the abdomen can also be harmful to the kidneys.

  • Bone, joint, and soft tissue problems

Surgery for bone or soft tissue cancers may cause a loss of the whole or part of a limb, which can be very difficult to cope with, both physically and mentally.

Chemotherapy, steroid medications, or hormonal therapy may cause thinning of the bones, called osteoporosis, or joint pain. Immunotherapy may cause problems in the joints or muscles. People who are not physically active may have a higher risk of these conditions.

Lowering the Risk of Osteoporosis

Cancer survivors can lower their risk of osteoporosis in these ways,

  • Avoiding tobacco products
  • Eating foods rich in calcium and vitamin D
  • Being physically active
  • Limiting how much alcohol they drink.





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