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Late Effects of Treatment for Childhood Cancer (PDQ®): Treatment - Patient Information [NCI] - General Information about Late Effects

Late effects are health problems that occur months or years after treatment has ended.

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.

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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 are both physical and emotional.

Late effects in childhood cancer survivors may affect the following:

  • Organs, tissues, and body function.
  • Growth and development.
  • Mood, feelings, and actions.
  • Thinking, learning, and memory.
  • Social and psychological adjustment.
  • Risk of second cancers.

There are three important factors that affect the risk of late effects.

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:

  • Tumor-related factors
    • Type of cancer.
    • Where the tumor is in the body.
    • How the tumor affects the way tissues and organs work.
  • Treatment-related factors
    • Type of surgery.
    • Chemotherapy type, dose, and schedule.
    • Radiation therapy type, part of the body treated, and dose.
    • Stem cell transplant.
    • Use of two or more types of treatment at the same time.
    • Blood product transfusion.
    • Chronic graft-versus-host disease.
  • Patient-related factors
    • The child's gender.
    • Certain changes in the child's genes.
    • Health problems the child had before being diagnosed with cancer.
    • The child's age at diagnosis and treatment.
    • Length of time since diagnosis and treatment.
    • Changes in hormone levels.
    • Family history of cancer or other conditions.
    • Health habits.

The chance of having late effects increases over time.

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:

  • The primary cancer comes back.
  • A second (different) primary cancer forms.
  • Heart and lung damage.
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