Key Points for This Section

Late effects are treatment-related health problems that appear months or years after treatment has ended. The risk of developing late effects is related to the type of cancer or type of treatment.

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.

Glossary Terms

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).

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also 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.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Treatment with drugs that kill cancer cells.

The process of identifying a disease, such as cancer, from its signs and symptoms.

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.

Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.

Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.

A part of the body that performs a specific function. For example, the heart is an organ.

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 irradiation and radiotherapy.

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.

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.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

A group or layer of cells that work together to perform a specific function.