Childhood Cancer Awareness Month: Late Effects

By Abby Henry, Oncology Content Manager, PearlPoint Cancer Support  

September is Childhood Cancer Awareness Month. Adult survivors of childhood cancer may still deal with the late effects of cancer and cancer treatment years after their last treatment. The late effects of childhood cancer can include many different parts of the body and differ from person to person. Predominately the risk of late effects depends on the following:

  • Type of cancer
  • Specific treatments received
  • Age at treatment
  • Gender
  • Lifestyle post-cancer treatment

If you are a childhood cancer survivor, be sure to discuss your risk for late effects with your healthcare team. Be sure to ask these questions:

  • Which late effects are you the most at risk for?
  • What are the sign and symptoms of these issues?
  • Do you need a screening schedule to check for late effects?
  • What can you do to prevent or lower your risk for late effects?

Here are just a few examples of late effects experienced by childhood blood cancer survivors adapted from the National Cancer Institute’s Late Effects of Treatment for Childhood Cancer:

Cognitive Issues
Patients who receive radiation, certain chemotherapies, or stem cell transplants are at risk for cognitive issues caused by damage to the brain and/or spinal cord. Cognitive issues can include memory problems, difficulty concentrating, and trouble problem solving. These are commonly referred to as “chemo brain.”

Heart Disease
Patients who receive radiation to the chest or certain chemotherapies as part of their treatment are at risk for cardiovascular damage such as weakened heart muscles, damage to the valves, and heart attack. Patients at the highest risk include— female patients, younger patients, and patients with other risk factors for heart disease such as obesity, smoking, diabetes, high blood pressure, high cholesterol, and family history of heart disease.

Fertility
Damage to reproductive organs can cause infertility in pediatric cancer patients. For male patients, damage to the testicles can result in low sperm count. For female patients, damages to the ovaries can cause early menopause or delays in puberty. Patients who receive certain chemotherapies, radiation to the stomach, or total body irradiation for stem cell transplants are at the highest risk for infertility. There are ways to preserve fertility, but these have to be done before treatment. Men can freeze and bank sperm. Women can freeze and bank eggs or embryos.

Endocrine System
Pediatric cancer patients are still growing and maturing. Cancer treatment can interfere with growth and development by damaging the endocrine system. The thyroid is part of the endocrine system so damage to the thyroid can cause thyroid dysfunction such as hyperthyroidism or hypothyroidism.

Bone Damage
For children whose bones are still growing, cancer treatment can be very damaging. Radiation can interfere with bone growth leading to shorter stature, scoliosis, and osteoporosis. Certain chemotherapies can also cause bones to be weak and to break more easily.

The list above only touches on a few of the late effects childhood cancer survivors may face later in life. Other late effects may include social and emotional problems. Childhood cancer survivors are also at an increased risk of a second cancer diagnosis later in life. Screening recommendations for breast cancer, colon cancer, and leukemia are different for childhood cancer survivors.

If you are a childhood cancer survivor, make sure you follow all screening recommendations, receive annual physicals, and provide your full medical history to any new members of your healthcare team.

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