For many people with cancer, chemotherapy is the best option for controlling their disease. You may be faced, however, with long-term side effects related to your chemotherapy treatments.
In some cases, side effects related to specific chemotherapy drugs can continue after the treatment is over. These effects can progress and become chronic, or new side effects may develop. Long-term side effects depend on the specific drugs received and whether you had other treatments, such as radiation therapy.
Permanent organ damage
Certain chemotherapy drugs may permanently damage the body’s organs. If the damage is detected during treatment, the drug is usually stopped, depending on which organs are affected and how serious it is. Still, some of the side effects may remain. Damage to some organs and organ systems, such as the reproductive system, may not show up until after chemotherapy is finished.
Delayed development in children
When young children receive chemotherapy for cancer treatment, it may affect their growth and their ability to learn. Several factors impact long-term side effects, including the age of the child, which drugs are given, the dosage and length of treatment, and whether chemotherapy is used along with other types of treatment, such as radiation.
More information on this and other long-term side effects that specifically impact children can be found in our document called Childhood Cancer: Late Effects of Cancer Treatment.
Nerve damage
Nervous system changes can develop months or years after treatment with some drugs. Signs of nerve damage may include hearing loss or tinnitus (ringing in the ears), changes in sensation (feeling) in the hands and feet, personality changes, sleepiness, impaired memory, shortened attention span, and seizures.
Blood in the urine
Hemorrhagic cystitis (blood in the urine) is a side effect of cyclophosphamide and ifosfamide. It can continue for some time and even worsen after the drug is stopped. Treatment is available for this problem.
Another cancer
Development of a second cancer is a great concern for cancer survivors. Some chemotherapy drugs raise the risk of developing another type of cancer later on. This risk is affected by many factors, including the age of the patient and whether or not other treatments like radiation were used. The most commonly reported secondary cancers are leukemias, lymphomas, and some solid tumors. To learn more about this, see Second Cancers Caused by Cancer Treatment.
Also keep in mind that having cancer once does not mean you cannot have an unrelated cancer in the future. Routine cancer check-ups and recommended cancer screening tests (for cancers like colon, cervical, and breast cancer) should be part of your health care for the rest of your life.
The importance of keeping records about your cancer treatment
Because of the delayed risk linked to several types of chemotherapy, it’s best to keep a list of all the types of cancer treatments you received, along with dates and doses. You will need to copy this list to share with any doctors you see in the future.
Another reason for keeping records of the type of cancer you have is that your children may want copies of your pathology reports and other information for their own medical histories or other reasons. Although doctors and hospitals may keep copies of these records for a limited time, finding them can become a problem when records are archived or destroyed after a certain retention period. This retention period (the length of time the records are kept) varies from state to state and practice to practice. Records may also disappear when a doctor retires, or if the clinic or office moves or closes.
Make sure you collect the following information during or very soon after treatment, and always keep copies for yourself:
- A copy of your pathology report from any biopsy or surgery
- If you had surgery, a copy of your operative report
- If you were hospitalized, a copy of the discharge summary that the doctor must prepare when a patient is sent home from the hospital
- A list of your drugs, their doses, and when you took them
- A summary of any radiation treatments that you were given
Following up with your doctor
Finally, routine follow-up care after treatment is finished is an essential component of cancer care for all cancer survivors. As you near the end of your chemotherapy, talk with your doctor about the expected follow-up schedule, and which tests — if any — will be needed and at what intervals. You might also want to talk about what symptoms you should look for and find out which doctor you should see for these symptoms.
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