Late Effects: Long Term General Health Concerns

A “late effect” is a side effect that occurs more than five years after a diagnosis of cancer caused by the use of treatments such as chemotherapy, radiation therapy, and surgery. The occurrence and type of late effects vary from person to person. Since so many people are living longer post-cancer, the detection and treatment of late effects is becoming a more important component of cancer care. 

Late Effects include problems that arise over time such as: 

  • Hearing loss 
  • Heart symptoms 
  • Hormonal problems 
  • Chronic fatigue 
  • Weight gain 
  • Bone loss 
  • Thyroid, kidney, or breathing problems 

Health care providers following cancer survivors should be aware of the risks for developing such medical problems— based upon the type of cancer and on the treatment a patient received. 

Although there are certain unavoidable problems that may result from cancer treatment in the short- and long-terms, many problems can be prevented or minimized with routine health monitoring. Long-term health risks related to treatment are based on individual risks: 

  • Your type and stage of cancer 
  • The treatment you received
  • The effectiveness of the treatment 
  • Your overall health after treatment 

Different treatments are linked to different risks for late effects.  Doctors should observe changes in the: 

  • Heart 
  • Joints and bones 
  • Lungs 
  • Mouth and teeth 
  • Liver 
  • Endocrine system 
  • Eyes 
  • Reproductive system 

Treatment also may raise the risk for second cancers, for example, a new solid tumor or leukemia in survivors of Hodgkin disease or non-Hodgkin lymphoma. Higher risk does not mean that late effects will happen. You and your doctor should pay attention to changes and monitor your health with the right tests. Late-effects vary for each cancer survivors, so we can not address each specific late effect or what your risk might be. We strongly encourage you to talk about your risks with the cancer specialists on your health care team. Your follow-up visits provide opportunities for you to raise questions or concerns. Ask what your specific risks are, how your doctor will monitor them, and what you can do to minimize future problems. 

Some resources with information about the late effects of cancer treatment: 

  • Cancer.Net , ASCO—provides detailed information about Survivorship, co-existing conditions, and follow-up plans after cancer treatment. 
  • Oncolink, Abramson Cancer Center of the University of Pennsylvania—provides articles and information for survivors.

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