“Late Effects” with Chemotherapy

Chemotherapy is a method of using chemicals, either individually or as a “cocktail mixture” and currently used to kill cancerous cells in the body. Chemotherapy may be administered via topical application, injection with a needle, orally via pills or drink, and intravenous IV. Each procedure using these different combinations of chemicals may have temporary side effects, lasting side effects and “late effects.

Side effects are a direct effect of the types of chemicals used that are immediately manifested such as nausea, diarrhea, vomiting, and, memory or cognitive problems (called chemo brain), fatigue, bleeding, and loss of hair. Lasting side effects may be loss of appetite, changes in the way food tastes, liver damage, or a host of other problems that began with treatment but continue to be a problem for months or years after treatment. Fortunately, long lasting effects normally do resolve on their own and disappear. However, what are late effects?

Late effects are a type of side effect that may not show up right away and, in fact, may not appear for years. Most cancer survivors find they do not know anything about this aspect of undergoing chemotherapy treatment and finding out they have late effects may surprise them. Although many doctors believe late effects are rare, the simple truth is that at least 40% of those undergoing chemotherapy are at risk of developing them long after treatment has ended.

Many patients claim they were never told of late effects. Unfortunately, many doctors were not aware of late effects or, if they had told the patient, the patient did not realize the difference or even remember. The answer may be that cancer patients are now living longer and with a better quality of life. With this, the possibility of late effects appearing has become more frequent. Previously, many patients may have died before any last effects appeared.

Late effects may involve a new type of cancer (or second cancer) appearing as tumors or another type of unrelated cancer to the first diagnosis. Damage may show up in the body organs, including the heart, lung (such as reduced lung capacity), and kidneys. Other late effects may turn up as nerve, bone (such as osteoporosis), soft tissue, dental (cavities, tooth decay and loss of enamel overall), vision (cataracts), digestive, brain, spinal cord, learning, memory, endocrine (hormone), and emotional problems. These are only a few that may occur.

If you were a child that was treated for any type of cancer, especially before 1988, let your primary care doctor know about it so he can do any needed testing and follow-up. The things happening to your body may be attributed to getting older, but it may go much deeper than that. Find out if what is going on with your body is normal or not.

It is important to talk to your doctor about any side effects you may suffer while undergoing chemotherapy treatment. Ask about last effects and what you may expect from the type of chemicals being used in your specific therapy regime. Ask about what signs or symptoms to keep an eye on and if you would need to see a specialist. Screening tests are important after treatment in order to identify any late effects that may appear. Testing may include a yearly thyroid examination, testing of the lungs, regular echocardiograms, blood tests, mammography, and imaging tests such as x-rays, cat scans, and MRI’s. After treatment, continue with follow-up treatment and keep copies of any records concerning your original chemotherapy. No one wants to undergo chemotherapy, but it does work for many people. Just be aware of the risks and talk to your doctor.

Sources:

Before and After Chemo

Cancer survivors: Managing late effects of cancer treatment

Late Effects – Cancer.Net