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Late Effects of Treatment for Childhood Cancer

Central Nervous System

Brain and spinal cord late effects are more likely to occur after treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause brain and spinal cord late effects:

Radiation to the brain increases the risk of brain and spinal cord late effects.

The risk of health problems that affect the brain or spinal cord increases after treatment with the following:

When radiation to the brain and intrathecal chemotherapy are given at the same time, the risk of late effects is higher.

The following may also increase the risk of brain and spinal cord late effects:

Late effects that affect the brain and spinal cord may cause certain health problems.

Childhood cancer survivors who received radiation, intrathecal chemotherapy, or surgery to the brain or spinal cord are at risk of late effects to the brain and spinal cord. These include the following:

Survivors may also have late effects that affect thinking, learning, and behavior. Newer ways of targeting therapy and using lower doses of radiation have fewer effects on thinking and functioning.

Possible signs of brain and spinal cord late effects include headaches, loss of coordination, and seizures.

These symptoms may be caused by brain and spinal cord late effects:

Other symptoms include the following:

Other conditions may cause the same symptoms. Talk to your doctor if you have any of these problems.

Certain tests and procedures are used to detect (find) and diagnose health problems in the brain and spinal cord.

These and other tests and procedures may be used to detect or diagnose brain and spinal cord late effects:

Talk to your doctor about whether you need to have tests and procedures to check for signs of brain and spinal cord late effects. If you do, find out how often they should be done.

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, the way they look, or the fear of cancer coming back. This may cause problems with personal relationships, education, employment, and health.

Yearly follow-up exams for childhood cancer survivors should include screening and treatment for possible psychological distress.

Some childhood cancer survivors have post-traumatic stress disorder.

Being diagnosed and treated for a life-threatening disease may be traumatic. This trauma may cause post-traumatic stress disorder (PTSD). PTSD is defined as having certain behaviors following a stressful event that involved death or the threat of death, serious injury, or a threat to oneself or others.

PTSD can affect cancer survivors in the following ways:

In general, childhood cancer survivors show low levels of PTSD, depending in part on the coping style of patients and their parents. Survivors who received radiation therapy to the head when younger than 4 years or survivors who received intensive treatment may be at higher risk of PTSD. 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 may be part of PTSD, survivors with PTSD may not get the medical treatment they need.

Teenagers who are diagnosed with cancer may have social problems later in life.

Teenagers who are diagnosed with cancer may reach fewer social milestones or reach them later in life than teenagers not diagnosed with cancer. Social milestones include having a first boyfriend, getting married, and having a child. They may also have trouble getting along with other people or feel like they are not liked by their peers.

Cancer survivors in this age group have reported being less satisfied with their health and their lives in general compared with others of the same age who did not have cancer. Teenagers and young adults who have survived cancer need special programs that provide psychological, educational, and employment support.