Common Late Effects from Pediatric Cancer Treatment

Advances in the ability to detect and treat cancer have led to greater survival rates. Today 80 percent of pediatric cancer patients will survive, but for many, life is never quite the same. Pediatric cancer treatments can cause serious, sometimes life-threatening late effects.

Fortunately, most long-term survivors will not experience late effects, but it’s important to catch problems early on. Common late effects include the following.

Growth- Treatment for pediatric cancer (particularly radiation to the brain or spine) can slow or stunt growth. Yearly height measurements and bone x-rays help predict normal height. At-risk patients will be referred to an endocrinologist.

Heart- A small percentage of pediatric cancer patients treated with chest radiation or certain drugs (daunomycin or doxorubicin) will experience heart disease. Patients treated with higher doses and those treated before their heart finished growing are at greatest risk and will be referred to a cardiologist, if needed, for regular EKGs and echocardiograms.

Fertility Radiation treatment and certain anticancer drugs can affect sexual development and reproduction. Some patients are at risk for delayed puberty, the inability to have children (called “infertility”), or early menopause. Physical exams and blood tests determine fertility problems, and once identified, patients are referred to fertility specialists.

Thyroid- Head or neck radiation can cause the thyroid gland to stop working properly. The thyroid gland helps regulate growth, weight, and the balance of body chemicals. Once blood tests indicate problems with thyroid hormone levels, patients are referred to an endocrinologist.

Secondary Cancers– Some chemotherapy drugs and radiation can increase the risk of a second (different) cancer. Certain patients are genetically more at risk for secondary cancers. Tobacco, excessive sun exposure, and other chemicals and behaviors can increase this risk. The survivorship team will educate patients about the importance of early detection and lowering risk for secondary cancers.

School and Work– Some cancer treatments can create problems for patients at school or work. They can undergo neuropsychological testing at the Texas Child Study Center Embedded Behavioral Clinic (TSCSC), located in the Children’s Blood & Cancer Center outpatient clinic, to identify emotional problems or problems with their ability to learn. The TCSC team will work with a patient’s school system to make sure all special educational needs are met. Financial assistance for education and job training may be available through government programs.