The cancer itself or the treatment of cancer may cause health problems for childhood cancer survivors months or years after successful treatment has ended. Cancer treatments may harm the body's organs, bones, or tissues and cause health problems later in life. These health problems are called late effects. Treatments that may cause late effects include surgery, chemotherapy, radiation therapy, or stem cell transplant.
Doctors are studying the late effects caused by cancer treatment. They are working to improve treatments and stop or lessen late effects. While most late effects are not life-threatening, they may cause serious problems that affect health and quality of life.
Late effects in childhood cancer survivors may affect the following:
Many childhood cancer survivors will have late effects. The risk of late effects depends on factors related to the patient, tumor, and treatment. These include the following:
New treatments for childhood cancer have decreased the number of deaths from the primary cancer. However, the number of late effects in childhood cancer survivors increases with longer time since treatment and with older age. Survivors may not live as long as people who did not have cancer. The most common causes of death in childhood cancer survivors are:
Studies of the causes of late effects have led to changes in treatment. This has improved the quality of life for cancer survivors and helps prevent illness and death from late effects.
Regular follow-up by health professionals who are experts in finding and treating late effects is important for the long-term health of childhood cancer survivors. Follow-up care will be different for each person who has been treated for cancer. The type of care will depend on the type of cancer, the type of treatment, genetic factors, and the person's general health and health habits.
It is important that childhood cancer survivors have an exam at least once a year. The exams should be done by a health professional who is familiar with the survivor's risk for late effects and can recognize the early signs of late effects. Blood and imaging tests may also be done.
Long-term follow-up may improve 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.
The quality of life enjoyed by cancer survivors may be improved by behaviors that promote health and well-being. These include 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, illegal drug use, sun exposure, or not being physically active may worsen treatment-related organ damage and possibly increase the risk of second cancers.