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Late Effects of Treatment for Childhood Cancer (PDQ®)     
Last Modified: 07/01/2008
Patient Version
Table of Contents

General Information About Late Effects
Central Nervous System
Senses
Digestive System
Spleen
Heart
Lung
Kidney
Thyroid
Neuroendocrine System
Musculoskeletal System
Reproductive System
Second Cancers
Mortality
Long-Term Follow-Up
To Learn More About Late Effects of Treatment for Childhood Cancer
Get More Information From NCI
Changes to This Summary (07/01/2008)
About PDQ

General Information About Late Effects

Key Points for This Section


Late effects are treatment-related health problems that appear months or years after treatment has ended.

The treatment of cancer may damage healthy cells at the same time it destroys cancer cells. Some cancer treatments, such as chemotherapy, radiation therapy, and bone marrow or stem cell transplant, stop the growth of rapidly dividing cells, such as cancer cells. Since bones, tissues, and organs that are growing with the child have cells that are also dividing rapidly, cancer treatment can prevent them from developing normally. Other cancer treatments include surgery to remove all or part of certain organs that have cancer in them. The damage from these cancer treatments can be mild or serious, and the effects may be seen during treatment or months to years later.

Side effects that continue or appear after cancer treatment has ended are called late effects. It is important for the parents and the patient to know that children treated for cancer (childhood cancer survivors) may develop late effects from their treatment.

Late effects of cancer treatment may affect the following in childhood cancer survivors:

  • Organs, bones, or body tissues.
  • Mood, feelings, and actions.
  • Thinking, learning, and memory.

The risk of developing late effects is related to the type of cancer or type of treatment.

The risk that a cancer treatment will cause late effects depends on many things, including the following:

  • The type of cancer and where it is in the body.
  • The child’s age (when treated).
  • The type and amount of treatment.
  • The area treated.
  • Genetic factors or health problems the child had before the cancer.

Regular follow-up by health professionals who are expert in finding and treating late effects is important for the long-term health of childhood cancer survivors. Records about the cancer diagnosis and treatment, including all test results, should be kept by childhood cancer survivors (or their caregivers). This information may be used to help find and treat late effects.

Doctors are studying the late effects that cancer treatments cause in childhood cancer survivors. They are trying to find out if changing treatment can help prevent or lessen late effects in childhood cancer survivors.

Central Nervous System

Key Points for This Section


Cancer treatments to the central nervous system (CNS) may affect the child's brain.

Childhood cancer survivors who received radiation therapy to the head, brain surgery, or intrathecal chemotherapy are at risk of having problems in the following areas:

  • Thinking.
  • Learning.
  • Problem solving.
  • Speech.
  • Reading.
  • Writing.
  • Memory.
  • Coordinating movement between the eyes, hands, and other muscles.

Survivors may have learning disabilities or a lower IQ.

Certain factors increase the risk that CNS late effects will occur.

The following factors may increase the risk of CNS late effects:

  • Being young at the time of treatment (the younger the child, the greater the risk).
  • Having a tumor in the CNS.
  • Receiving certain combinations of treatment, such as high-dose chemotherapy and radiation therapy to the brain.

CNS late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause CNS late effects:

Survivors of childhood cancer may have anxiety and depression related to their cancer.

Survivors of childhood cancer may have anxiety and depression related to physical changes, appearance, or the fear of cancer coming back. These problems may prevent survivors from returning to their normal routines and activities. They may also cause problems with personal relationships, education, employment, and health.

Some cancer survivors have post-traumatic stress disorder.

Being diagnosed with a life-threatening disease and receiving treatment for it is often traumatic. This trauma may cause a group of symptoms called post-traumatic stress disorder (PTSD). PTSD is defined as having certain symptoms following a stressful event that involved death or the threat of death, serious injury, or a threat to oneself or others. People who have survived very stressful situations, such as military combat or natural disasters, may also have PTSD.

PTSD can affect cancer survivors in the following ways:

  • Reliving the time they were diagnosed and treated for cancer, in nightmares or flashbacks, and thinking about it all the time.
  • Avoiding places, events, and people that remind them of the cancer experience.
  • Being constantly overexcited, fearful, irritable, or unable to sleep, or having trouble concentrating.

Family problems, little or no social support from family or friends, and stress not related to the cancer may increase the chances of having PTSD. Because avoiding places and persons connected to the cancer is part of PTSD, survivors with PTSD may not try to get the medical treatment they need.

Senses

Key Points for This Section


Ears

Childhood cancer survivors may have late effects that affect hearing.

Certain factors increase the risk that hearing loss will occur.

The risk of hearing loss may be increased in childhood cancer survivors who received either of the following:

Risk may also be increased in childhood cancer survivors who were young at the time of treatment (the younger the child, the greater the risk).

Hearing late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause hearing late effects:

Eyes

Childhood cancer survivors may have late effects that affect the eyes.

Eye late effects may include the following:

  • Bone growth problems around the eye socket that affect the shape of the child’s face as it grows.
  • Dry eye.
  • Cataracts.
  • Damage to the optic nerve and retina.
  • Poor vision.
  • Drooping eyelids.
  • Eyelid tumors.

Certain factors increase the risk that damage to the eye or eye socket will occur.

The following may increase the risk of damage to the eye or eye socket:

  • Being younger than 1 year at the time of treatment.
  • Tumor of the retina.

The risk may also be increased in childhood cancer survivors who had either of the following:

Eye late effects may be caused by radiation treatments for certain childhood cancers.

Radiation therapy for these and other childhood cancers may cause eye late effects:

Digestive System

Key Points for This Section


Teeth and jaw

Childhood cancer survivors may have late effects that affect the teeth and jaw.

Teeth and jaw late effects may include the following:

  • Teeth are small or do not have a normal shape.
  • The roots of the teeth are short.
  • Missing teeth.
  • New teeth come in at a later than normal age.
  • The head and face do not reach full growth.
  • Tooth enamel is not normal.
  • Salivary glands do not make enough saliva.
  • Tooth decay (including cavities) and gum disease.

Certain factors increase the risk that teeth and jaw late effects will occur.

The risk of teeth and jaw late effects may be increased in childhood cancer survivors who received any of the following:

Risk may also be increased in survivors who were younger than 3 years at the time of treatment.

It is important that childhood cancer survivors have regular dental checkups to help prevent or detect infection or decay.

Teeth and jaw late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause teeth and jaw late effects:

Liver

Childhood cancer survivors may have late effects that affect the liver.

Liver late effects may include the following:

Hepatic fibrosis, hepatitis C infection, and veno-occlusive disease can cause long-term problems.

Certain factors increase the risk that liver late effects will occur.

The risk of liver late effects may be increased in childhood cancer survivors who received any of the following:

Risk may also be increased in survivors who had liver disease before treatment or developed veno-occlusive disease during treatment.

Liver late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause liver late effects:

Digestive tract

Childhood cancer survivors may have late effects that affect the digestive tract.

Digestive tract late effects may include the following:

These effects may be caused by damage to the blood vessels, which may lead to long-term problems.

Radiation therapy to the abdomen may damage blood vessels and increase the risk of digestive tract late effects.

Digestive tract late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause digestive tract late effects:

Spleen

Key Points for This Section


Childhood cancer survivors may have late effects that affect the spleen.

Spleen late effects may increase the risk of life-threatening bacterial infections.

Certain factors increase the risk that spleen late effects will occur.

The risk of spleen late effects may be increased in childhood cancer survivors who received either of the following:

It is very important that childhood cancer survivors who received either of these treatments keep immunizations up-to-date and receive antibiotics before having any dental work.

Spleen late effects may be caused by treatment for childhood Hodgkin lymphoma and other childhood cancers.

Heart

Key Points for This Section


Childhood cancer survivors may have late effects that affect the heart.

Heart late effects may include the following:

  • Abnormal heartbeat.
  • Disease of the heart muscle.
  • Congestive heart failure.
  • Increased risk of stroke, blood clots, and chest pains.
  • Tiring quickly during exercise.
  • Coronary artery disease (hardening of the heart arteries).

Certain factors may increase the risk that heart late effects will occur.

The following may increase the risk of heart late effects:

This risk may also increase as the amounts of anthracycline drugs and radiation used increase and as the time since treatment gets longer.

Heart late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause heart late effects:

Lung

Key Points for This Section


Childhood cancer survivors may have late effects that affect the lungs.

Lung late effects may include the following:

Certain factors increase the risk that lung problems will occur.

The risk of lung late effects may be increased in childhood cancer survivors who had either of the following:

Risk may also be increased in survivors who received any of the following:

Lung late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause lung late effects:

Kidney

Key Points for This Section


Childhood cancer survivors may have late effects that affect the kidneys.

Kidney late effects may include the following:

Certain factors increase the risk that kidney problems will occur.

The following may increase the risk of kidney late effects:

  • Having cancer in both kidneys.
  • Being young at the time of treatment (the younger the child, the greater the risk).
  • Having a genetic syndrome that increases the risk of kidney problems, such as Denys-Drash syndrome.

Risk may also be increased in childhood cancer survivors who received any of the following:

Kidney late effects may be caused by treatment for Wilms’ tumor and other childhood cancers.

Thyroid

Key Points for This Section


Childhood cancer survivors may have late effects that affect the thyroid.

Thyroid late effects may include the following:

Certain factors increase the risk that thyroid problems will occur.

The risk of thyroid late effects may be increased in childhood cancer survivors who received either of the following:

The risk may also be greater in females and may increase as the amount of time since diagnosis gets longer.

Thyroid late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause thyroid late effects:

Neuroendocrine System

Key Points for This Section


Childhood cancer survivors may have late effects that affect the neuroendocrine system.

Neuroendocrine late effects may include the following:

Childhood cancer survivors who received a stem cell transplant with total-body irradiation (TBI) have an increased risk of growth disorders.

Their risk is affected as follows:

  • Low levels of growth hormone are more likely if the survivor:
  • Adult height that is shorter than normal is more likely if the survivor:
    • is male; or
    • received the transplant at a young age; or
    • received TBI in a single dose instead of divided doses.

Neuroendocrine late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause neuroendocrine late effects:

Musculoskeletal System

Key Points for This Section


Bone

Childhood cancer survivors may have late effects that affect the bones.

Bone late effects may include the following:

  • Bone pain.
  • Joint stiffness.
  • Weak or thin bones that can break easily.
  • Decreased amounts of calcium in bones.
  • Decreased bone and tissue growth in treated areas.

Certain factors increase the risk that bone late effects will occur.

The following may increase the risk of bone late effects:

  • Being female.
  • Being older at the time of treatment.
  • Having low levels of estrogen or growth hormone.

Risk may also be increased in childhood cancer survivors who received either of the following:

Bone late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause bone late effects:

Body weight

Childhood cancer survivors may have late effects that affect body weight and cause obesity.

The following may increase the risk of obesity:

  • Being female and having received treatment at age 4 years or younger, with high- dose radiation therapy to the head.
  • Being young at the time of treatment (the younger the child, the greater the risk).
  • Being slender at the time of diagnosis.
  • Having an increase in body fat at an earlier than normal age.

Obesity may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause obesity:

Reproductive System

Key Points for This Section


Testicles

Childhood cancer survivors may have late effects that affect the testicles.

Testicular late effects may cause infertility or a low sperm count. Low sperm counts may be temporary or permanent depending on the radiation dose and schedule, the area of the body treated, and the age when treated.

Certain factors increase the risk that testicular late effects will occur.

The risk of testicular late effects may be increased in childhood cancer survivors who received either of the following:

Testicular late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause testicular late effects:

Ovaries

Childhood cancer survivors may have late effects that affect the ovaries.

Ovarian late effects may include the following:

Certain factors increase the risk that ovarian late effects will occur.

The risk of ovarian late effects may be increased in childhood cancer survivors who received any of the following:

Uterus

Childhood cancer survivors may have late effects that affect the uterus.

The uterus may become less elastic and grow to a size that is smaller than normal. This can cause an increased risk of miscarriage and premature birth. Growth of the fetus within the uterus may also be affected.

The risk of uterine late effects may be increased in women who received radiation therapy to the abdomen.

Ovarian and uterine late effects may be caused by treatment for childhood osteosarcoma and other childhood cancers.

Reproduction

Childhood cancer survivors may have late effects that affect pregnancies.

Late effects on pregnancies include increased risk of the following:

  • Miscarriage.
  • Ending the pregnancy for medical reasons.
  • Low birth-weight babies.
  • Early labor.
  • Premature delivery.
  • Abnormal position of the fetus.
  • Birth defects.

For male survivors of childhood cancer, there is an increased risk that their children may be stillborn.

Certain stem cell and bone marrow transplants increase the risk of infertility.

Stem cell and bone marrow transplants that include total-body irradiation (TBI), cyclophosphamide, or busulfan may damage the ovaries. Problems with the ovaries, fertility, and the ability to carry a baby to term may occur.

There are methods that may be used to help childhood cancer survivors have children.

The following methods may be used so that childhood cancer survivors can have children:

  • Freezing the eggs or sperm before cancer treatment in patients who have reached puberty.
  • In vitro fertilization (IVF).

There is a risk that there may be cancer cells in the saved eggs, sperm, or embryo. This risk is highest in patients who had cancer of the blood, testicles, or ovaries.

Children of childhood cancer survivors are usually not affected by a parent’s prior cancer treatment.

Survivors of childhood cancer may wonder if their children will have birth defects, inherited diseases, or cancer. There is a small increase in the risk of birth defects in the children of females who received radiation therapy to the lower back, but most children of childhood cancer survivors are born healthy.

There may be an increased risk of birth defects in children whose embryos were created in the laboratory and an increased risk of cancer in the children of cancer survivors who had second cancers.

Second Cancers

Key Points for This Section


Childhood cancer survivors have an increased risk of developing a second cancer later in life.

Certain factors related to treatment increase the risk of second cancers. These include the following:

Childhood cancer survivors with certain genetic syndromes have an increased risk of developing a second cancer.

Some childhood cancer survivors have an increased risk of developing a second cancer because they have certain genetic syndromes that also placed them at risk of developing the primary cancer. These include the following:

Frequent and careful follow-up exams are very important for these childhood cancer survivors.

Mortality

Improvements in cancer treatment have decreased the number of deaths from primary cancer. The number of late effects in childhood cancer survivors may increase with age, however, and survivors may not live as long as people who did not have cancer. The most common causes of death in childhood cancer survivors include the following:

Studies of the causes of late effects have led to changes in treatment. This has improved the quality of life for cancer survivors and helped to prevent deaths from late effects.

Long-Term Follow-Up

Key Points for This Section


Regular follow-up care is very important for survivors of childhood cancer.

Follow-up care will be different for each person who has been treated for cancer, depending on the type of cancer, the type of treatment, and the person's general health. It is important that childhood cancer survivors receive regular exams by a health care provider who is familiar with their treatments and risks and who can recognize the early signs of late effects.

Childhood cancer survivors are more likely to need special education services, especially survivors of central nervous system tumors, leukemia, and Hodgkin disease.

The childhood cancer survivor's follow-up care will go on into adulthood. It ideally includes the survivor’s primary doctor and specialists; educational, vocational, and social service systems; and the family.

Long-term follow-up improves the health and quality of life for cancer survivors and also helps doctors study the late effects of cancer treatments so that safer therapies for newly diagnosed children may be developed.

Behaviors that promote health are important for survivors of childhood cancer.

The quality of life enjoyed by cancer survivors may be improved by behaviors that promote their future health and well-being, such as a healthy diet, exercise, and regular medical and dental checkups. These self-care behaviors are especially important for cancer survivors because of their risk of treatment-related health problems. Healthy behaviors may make late effects less severe and lower the risk of other diseases.

Avoiding behaviors that are damaging to health is also important. Smoking, excess alcohol use, and the use of illegal drugs increase the risk of organ damage and, possibly, of second cancers.

To Learn More About Late Effects of Treatment for Childhood Cancer

For more information from the National Cancer Institute about late effects of treatment for childhood cancer, see the following:

For more childhood cancer information and other general cancer resources from the National Cancer Institute, see the following:

Get More Information From NCI

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The NCI Web site 17 provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.

There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.

Find Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator 18. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

Changes to This Summary (07/01/2008)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

The following changes were made:

  • A new section called “ To Learn More 19 ” was added. It includes links to more information about late effects and about childhood cancer in general.
  • The “Get More Information from NCI” section (originally called “To Learn More”) was revised.

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site 17. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." In the United States, about two-thirds of children with cancer are treated in a clinical trial at some point in their illness.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site 20. Descriptions of the trials are available in health professional and patient versions. For additional help in locating a childhood cancer clinical trial, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

The PDQ database contains listings of groups specializing in clinical trials.

The Children's Oncology Group (COG) is the major group that organizes clinical trials for childhood cancers in the United States. Information about contacting COG is available on the NCI Web site 17 or from the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

The PDQ database contains listings of cancer health professionals and hospitals with cancer programs.

Because cancer in children and adolescents is rare, the majority of children with cancer are treated by health professionals specializing in childhood cancers, at hospitals or cancer centers with special facilities to treat them. The PDQ database contains listings of health professionals who specialize in childhood cancer and listings of hospitals with cancer programs. For help locating childhood cancer health professionals or a hospital with cancer programs, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.


Glossary Terms

abdomen (AB-doh-men)
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
abnormal
Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.
acute lymphoblastic leukemia (uh-KYOOT LIM-foh-BLAS-tik loo-KEE-mee-uh)
An aggressive (fast-growing) type of leukemia (blood cancer) in which too many lymphoblasts (immature white blood cells) are found in the blood and bone marrow. Also called ALL and acute lymphocytic leukemia.
alkylating agent (AL-kuh-LAY-ting AY-jent)
A type of drug that is used in the treatment of cancer. It interferes with the cell's DNA and inhibits cancer cell growth.
anthracycline (AN-thruh-SY-klin)
A type of antibiotic that comes from certain types of Streptomyces bacteria. Anthracyclines are used to treat many types of cancer. Anthracyclines damage the DNA in cancer cells, causing them to die. Daunorubicin, doxorubicin, and epirubicin are anthracyclines.
antibiotic (an-tih-by-AH-tik)
A drug used to treat infections caused by bacteria and other microorganisms.
antifungal
A drug that treats infections caused by fungi.
bacteria (bak-TEER-ee-uh)
A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.
bleomycin
An anticancer drug that belongs to the family of drugs called antitumor antibiotics.
blood
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
blood transfusion
The administration of blood or blood products into a blood vessel.
blood vessel
A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.
bone marrow transplantation (bone MAYR-oh tranz-plan-TAY-shun)
A procedure to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (an individual's own marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).
bowel (BOW-ul)
The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. Also called the intestine.
brain tumor
The growth of abnormal cells in the tissues of the brain. Brain tumors can be benign (non-cancerous) or malignant (cancerous).
breast (brest)
Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
busulfan
An anticancer drug that belongs to the family of drugs called alkylating agents.
calcium (KAL-see-um)
A mineral found in teeth, bones, and other body tissues.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.
carboplatin (KAR-boh-pla-tin)
A drug that is used to treat symptoms of ovarian cancer that has come back after treatment with other anticancer drugs or to treat advanced ovarian cancer that has never been treated. It is also used together with other anticancer drugs to treat non-small cell lung cancer and is being studied in the treatment of other types of cancer. Carboplatin is a form of cisplatin that causes fewer side effects in patients. It attaches to DNA (the molecules inside cells that carry genetic information and pass it from one generation to the next) and may cause cancer cells to die. It is a type of platinum compound.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
central nervous system (SEN-trul NER-vus SIS-tem)
CNS. The brain and spinal cord. Also called CNS.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
cholesterol (kuh-LESS-tuh-rawl)
A waxy, fat-like substance made in the liver, and found in the blood and in all cells of the body. Cholesterol is important for good health and is needed for making cell walls, tissues, hormones, vitamin D, and bile acid. Cholesterol also comes from eating foods taken from animals such as egg yolks, meat, and whole-milk dairy products. Too much cholesterol in the blood may build up in blood vessel walls, block blood flow to tissues and organs, and increase the risk of developing heart disease and stroke.
chronic (KRAH-nik)
A disease or condition that persists or progresses over a long period of time.
cisplatin (sis-PLA-tin)
A drug used to treat many types of cancer. Cisplatin contains the metal platinum. It kills cancer cells by damaging their DNA and stopping them from dividing. Cisplatin is a type of alkylating agent.
CNS
Central nervous system. The brain and spinal cord. Also called central nervous system.
CNS tumor
Central nervous system tumor. A tumor of the central nervous system (CNS), including brain stem glioma, craniopharyngioma, medulloblastoma, and meningioma. Also called central nervous system tumor.
congestive heart failure
Weakness of the heart muscle that leads to a buildup of fluid in body tissues.
connective tissue
Supporting tissue that surrounds other tissues and organs. Specialized connective tissue includes bone, cartilage, blood, and fat.
cyclophosphamide
An anticancer drug that belongs to the family of drugs called alkylating agents.
dexamethasone
A synthetic steroid (similar to steroid hormones produced naturally in the adrenal gland). Dexamethasone is used to treat leukemia and lymphoma and may be used to treat some of the problems caused by other cancers and their treatment.
diabetes (dye-a-BEE-teez)
A disease in which the body does not properly control the amount of sugar in the blood. As a result, the level of sugar in the blood is too high. This disease occurs when the body does not produce enough insulin or does not use it properly.
diagnosis (DY-ug-NOH-sis)
The process of identifying a disease, such as cancer, from its signs and symptoms.
diarrhea
Frequent and watery bowel movements.
diet
The things a person eats and drinks.
digestive tract (dy-JES-tiv)
The organs through which food and liquids pass when they are swallowed, digested, and eliminated. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum and anus.
disorder (dis-OR-der)
In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.
dose
The amount of medicine taken, or radiation given, at one time.
doxorubicin (DOK-soh-ROO-bih-sin)
A drug that is used to treat many types of cancer and is being studied in the treatment of other types of cancer. Doxorubicin comes from the bacterium Streptomyces peucetius. It damages DNA (the molecules inside cells that carry genetic information) and stops cells from growing. Rapidly growing tumor cells that take up doxorubicin may die. It is a type of anthracycline antitumor antibiotic. Also called doxorubicin hydrochloride, Adriamycin PFS, Adriamycin RDF, and Rubex.
drug
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
embryo
Early stage in the development of a plant or an animal. In vertebrate animals (have a backbone or spinal column), this stage lasts from shortly after fertilization until all major body parts appear. In particular, in humans, this stage lasts from about 2 weeks after fertilization until the end of the seventh or eighth week of pregnancy.
estrogen (ES-truh-jin)
A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.
familial polyposis (fuh-MIH-lee-ul PAH-lee-POH-sis)
An inherited condition in which numerous polyps (growths that protrude from mucous membranes) form on the inside walls of the colon and rectum. It increases the risk of colorectal cancer. Also called familial adenomatous polyposis and FAP.
family history
A record of a person's current and past illnesses, and those of his or her parents, brothers, sisters, children, and other family members. A family history shows the pattern of certain diseases in a family, and helps to determine risk factors for those and other diseases.
Fanconi syndrome (fan-KOH-nee SIN-drome)
A group of kidney disorders that cause protein, sugar, minerals, and other nutrients to be lost in the urine. Symptoms include weakness, bone pain, and passing a greater than normal amount of urine. One form of Fanconi syndrome is inherited and is usually found in infants. Fanconi’s syndrome may also be caused by other diseases, a lack of vitamin D, or exposure to heavy metals or chemicals, including certain anticancer drugs.
fertility (fer-TIL-i-tee)
The ability to produce children.
fetus (FEET-us)
The developing offspring from 7 to 8 weeks after conception until birth.
fibrosis
The growth of fibrous tissue.
follow-up
Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.
genetic (jeh-NEH-tik)
Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.
goiter (GOY-ter)
An enlarged thyroid. It may be caused by too little iodine in the diet or by other conditions. Most goiters are not cancer.
graft-versus-host disease (... dih-ZEEZ)
A disease caused when cells from a donated stem cell graft attack the normal tissue of the transplant patient. Symptoms include jaundice, skin rash or blisters, a dry mouth, or dry eyes. Also called GVHD.
hepatic (hih-PA-tik)
Refers to the liver.
hepatic veno-occlusive disease
A condition in which some of the veins in the liver are blocked. It is sometimes a complication of high-dose chemotherapy given before a bone marrow transplant and is marked by increases in weight, liver size, and blood levels of bilirubin.
hepatitis C virus (HEH-puh-TY-tis ... VY-rus)
A virus that causes hepatitis (inflammation of the liver). It is carried and passed to others through blood or sexual contact. Also, infants born to infected mothers may become infected with the virus.
high-dose chemotherapy (hy-dose kee-moh-THAYR-uh-pee)
An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.
Hodgkin disease (HOJ-kin dih-ZEEZ)
A cancer of the immune system that is marked by the presence of a type of cell called the Reed-Sternberg cell. The two major types of Hodgkin disease are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Symptoms include the painless enlargement of lymph nodes, spleen, or other immune tissue. Other symptoms include fever, weight loss, fatigue, or night sweats. Also called Hodgkin lymphoma.
Hodgkin lymphoma (HOJ-kin lim-FOH-muh)
A cancer of the immune system that is marked by the presence of a type of cell called the Reed-Sternberg cell. The two major types of Hodgkin lymphoma are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Symptoms include the painless enlargement of lymph nodes, spleen, or other immune tissue. Other symptoms include fever, weight loss, fatigue, or night sweats. Also called Hodgkin disease.
hormone (HOR-mone)
One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
hypertension (HY-per-TEN-shun)
A blood pressure of 140/90 or higher. Hypertension usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called high blood pressure.
hyperthyroidism (HY-per-THY-ROY-dih-zum)
Too much thyroid hormone. Symptoms include weight loss, chest pain, cramps, diarrhea, and nervousness. Also called overactive thyroid.
hypothalamus (hye-po-THAL-uh-mus)
The area of the brain that controls body temperature, hunger, and thirst.
hypothyroidism (HY-poh-THY-ROY-dih-zum)
Too little thyroid hormone. Symptoms include weight gain, constipation, dry skin, and sensitivity to the cold. Also called underactive thyroid.
ifosfamide
An anticancer drug that belongs to the family of drugs called alkylating agents.
immunization
A technique used to cause an immune response that results in resistance to a specific disease, especially an infectious disease.
in vitro (in VEE-troh)
In the laboratory (outside the body). The opposite of in vivo (in the body).
infection
Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.
infertility (IN-fer-TIH-lih-tee)
The inability to produce children.
inflammation (IN-fluh-MAY-shun)
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
inherited (in-HAYR-it-ed)
Transmitted through genes that have been passed from parents to their offspring (children).
intestine (in-TES-tin)
The long, tube-shaped organ in the abdomen that completes the process of digestion. The intestine has two parts, the small intestine and the large intestine. Also called the bowel.
intrathecal chemotherapy (IN-truh-THEE-kul KEE-moh-THAYR-uh-pee)
Treatment in which anticancer drugs are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord.
kidney (KID-nee)
One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.
late effects
Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.
leukemia (loo-KEE-mee-uh)
Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.
Li-Fraumeni syndrome
A rare, inherited predisposition to multiple cancers, caused by an alteration in the p53 tumor suppressor gene.
liver
A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
lung
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
lymphoma (lim-FOH-muh)
Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.
mechlorethamine (meh-klor-EH-thuh-meen)
A drug used to treat some types of cancer and some precancerous skin conditions. It attaches to the cell's DNA and may cause cancer cells to die. Mechlorethamine is a type of alkylating agent. Also called mustine, mechlorethamine hydrochloride, and Mustargen.
menopause (MEH-nuh-PAWZ)
The time of life when a woman's menstrual periods stop. A woman is in menopause when she hasn't had a period for 12 months in a row. Also called change of life.
menstrual cycle (MEN-stroo-al)
The monthly cycle of hormonal changes from the beginning of one menstrual period to the beginning of the next.
nasopharynx (NAY-zoh-fayr-inx)
The upper part of the throat behind the nose. An opening on each side of the nasopharynx leads into the ear.
National Cancer Institute
The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. The National Cancer Institute conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the National Cancer Institute Web site at http://www.cancer.gov. Also called NCI.
neuroblastoma (NOOR-oh-blas-TOH-muh)
Cancer that arises in immature nerve cells and affects mostly infants and children.
neuroendocrine (NOOR-oh-EN-doh-krin)
Having to do with the interactions between the nervous system and the endocrine system. Neuroendocrine describes certain cells that release hormones into the blood in response to stimulation of the nervous system.
non-Hodgkin lymphoma (non-HOJ-kin lim-FOH-muh)
Any of a large group of cancers of the immune system. Non-Hodgkin lymphomas can occur at any age and are often marked by enlarged lymph nodes, fever, and weight loss. There are many different types of non-Hodgkin lymphoma, which can be divided into aggressive (fast-growing) and indolent (slow-growing) types and can be classified as either B-cell or T-cell non-Hodgkin lymphoma. B-cell non-Hodgkin lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, immunoblastic large cell lymphoma, precursor B-lymphoblastic lymphoma, and mantle cell lymphoma. T-cell non-Hodgkin lymphomas include mycosis fungoides, anaplastic large cell lymphoma, and precursor T-lymphoblastic lymphoma. Lymphomas related to lymphoproliferative disorders following bone marrow or stem cell transplantation are usually B-cell non-Hodgkin lymphomas. Prognosis and treatment depend on the stage and type of disease. Also called NHL.
nutrient (NOO-tree-ent)
A chemical compound (such as protein, fat, carbohydrate, vitamin, or mineral) contained in foods. These compounds are used by the body to function and grow.
obese
Having an abnormally high, unhealthy amount of body fat.
optic nerve
The nerve that carries messages from the retina to the brain.
organ
A part of the body that performs a specific function. For example, the heart is an organ.
osteosarcoma (OS-tee-oh-sar-KOH-muh)
A cancer of the bone that usually affects the large bones of the arm or leg. It occurs most commonly in young people and affects more males than females. Also called osteogenic sarcoma.
ovarian (oh-VAYR-ee-un)
Having to do with the ovaries, the female reproductive glands in which the ova (eggs) are formed. The ovaries are located in the pelvis, one on each side of the uterus.
ovary (OH-vuh-ree)
One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.
overweight
Being too heavy for one’s height. Excess body weight can come from fat, muscle, bone, and/or water retention. Being overweight does not always mean being obese.
PDQ
PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.
pituitary gland (pih-TOO-ih-TAYR-ee...)
The main endocrine gland. It produces hormones that control other glands and many body functions, especially growth.
platinum
A metal that is an important component of some anticancer drugs, such as cisplatin and carboplatin.
pleura (PLOOR-uh)
A thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity. It protects and cushions the lungs. This tissue secretes a small amount of fluid that acts as a lubricant, allowing the lungs to move smoothly in the chest cavity while breathing.
pneumonia (noo-MOH-nyuh)
A severe inflammation of the lungs in which the alveoli (tiny air sacs) are filled with fluid. This may cause a decrease in the amount of oxygen that blood can absorb from air breathed into the lung. Pneumonia is usually caused by infection but may also be caused by radiation therapy, allergy, or irritation of lung tissue by inhaled substances. It may involve part or all of the lungs.
portal vein
A blood vessel that carries blood to the liver from the stomach, small and large intestines, spleen, pancreas, and gallbladder. Also called hepatic portal vein.
primary tumor
The original tumor.
procarbazine
A drug that is used to treat cancer. It belongs to the family of drugs called alkylating agents.
pulmonary (PUL-moh-nayr-ee)
Having to do with the lungs.
quality of life
The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.
radiation (RAY-dee-AY-shun)
Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.
relapse
The return of signs and symptoms of cancer after a period of improvement.
renal tubular acidosis (REE-nul TOO-byoo-ler A-sih-DOH-sis)
A rare disorder in which structures in the kidney that filter the blood are impaired, producing urine that is more acid than normal.
retinoblastoma (REH-tih-noh-blas-TOH-muh)
Cancer that forms in the tissues of the retina (the light-sensitive layers of nerve tissue at the back of the eye). Retinoblastoma usually occurs in children younger than 5 years. It may be hereditary or nonhereditary (sporadic).
rhabdomyosarcoma (RAB-doh-MY-oh-sar-KOH-muh)
Cancer that forms in the soft tissues in a type of muscle called striated muscle. Rhabdomyosarcoma can occur anywhere in the body.
risk factor
Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.
saliva (suh-LIE-vuh)
The watery fluid in the mouth made by the salivary glands. Saliva moistens food to help digestion and it helps protect the mouth against infections.
salivary gland (SA-lih-VAYR-ee gland)
A gland in the mouth that produces saliva.
sarcoma
A cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
second primary cancer
Refers to a new primary cancer in a person with a history of cancer.
side effect
A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.
soft tissue
Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body.
solid tumor
An abnormal mass of tissue that usually does not contain cysts or liquid areas. Solid tumors may be benign (not cancerous), or malignant (cancerous). Different types of solid tumors are named for the type of cells that form them. Examples of solid tumors are sarcomas, carcinomas, and lymphomas. Leukemias (cancers of the blood) generally do not form solid tumors.
sperm (spurm)
The male reproductive cell, formed in the testicle. A sperm unites with an egg to form an embryo.
spine
The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spine encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spinal column, and vertebral column.
spleen
An organ that is part of the lymphatic system. The spleen makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach.
splenectomy (spleh-NEK-toh-mee)
An operation to remove the spleen.
stem cell transplantation (stem sel tranz-plan-TAY-shun)
A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.
steroid drug (STAYR-oyd)
A type of drug used to relieve swelling and inflammation. Some steroid drugs may also have antitumor effects.
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
symptom
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
syndrome (SIN-drome)
A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.
testicle (TES-tih-kul)
One of two egg-shaped glands inside the scrotum that produce sperm and male hormones. Also called testis.
therapy (THAYR-uh-pee)
Treatment.
thioguanine
An anticancer drug that belongs to the family of drugs called antimetabolites.
thyroid (THY-royd)
A gland located beneath the voice box (larynx) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism.
thyroid hormone (THY-royd HOR-mone)
A hormone that affects heart rate, blood pressure, body temperature, and weight. Thyroid hormone is made by the thyroid gland and can also be made in the laboratory.
tissue (TISH-oo)
A group or layer of cells that work together to perform a specific function.
total-body irradiation
Radiation therapy to the entire body. It is usually followed by bone marrow or peripheral stem cell transplantation.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.
ulceration
The formation of a break on the skin or on the surface of an organ. An ulcer forms when the surface cells die and are cast off. Ulcers may be associated with cancer and other diseases.
uterus (YOO-ter-us)
The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the womb.
Wilms tumor
A disease in which malignant (cancer) cells are found in the kidney, and may spread to the lungs, liver, or nearby lymph nodes. Wilms tumor usually occurs in children younger than 5 years old.


Table of Links

1http://www.cancer.gov/cancertopics/coping/childhood-cancer-survivor-study
2http://www.survivorshipguidelines.org
3http://www.childrensoncologygroup.org/Surveys/lateEffects/lateEFfects.PublicSea
rch.asp
4http://www.cancer.gov/cancertopics/wyntk/overview
5http://www.cancer.gov/cancertopics/types/childhoodcancers
6http://www.curesearch.org
7http://cancer.gov/cancertopics/pdq/treatment/lateeffects/Patient
8http://www.cancer.gov/cancertopics/youngpeople
9http://www.cancer.gov/cancertopics/factsheet/NCI/children-adolescents
10http://www.cancer.gov/cancertopics/understandingcancer/cancer
11http://www.cancer.gov/cancertopics/factsheet/Detection/staging
12http://www.cancer.gov/cancertopics/coping
13http://www.cancer.gov/cancertopics/support
14http://www.cancer.gov/cancertopics/literature
15http://dccps.nci.nih.gov/ocs/resources.html
16https://cissecure.nci.nih.gov/livehelp/welcome.asp
17http://cancer.gov
18https://cissecure.nci.nih.gov/ncipubs
19http://cancer.gov/cancertopics/pdq/treatment/lateeffects/Patient/597.cdr#Sectio
n_597
20http://cancer.gov/clinical_trials