Late and Long-Term Effects of Neuroblastoma and Its Treatment

Both neuroblastoma itself and its treatment can sometimes result in long-lasting effects.

In very rare instances and for unknown reasons, in some children with neuroblastoma the body’s immune system attacks the child’s normal nerve tissue. This can lead to problems such as learning disabilities, delays in muscle development, language problems, and behavioral problems. Children whose tumors arise in the neck or chest and who have problems with the eyes or with muscle twitches may need further treatment with corticosteroids or other hormones to help keep their immune system in check.

Because of major advances in treatment, most children treated for neuroblastoma are now surviving into adulthood. Doctors have learned that the treatment can affect children’s health later in life, so watching for health effects as they get older has become more of a concern in recent years.

Treating childhood cancer requires a very specialized approach, and so does the care and follow-up after treatment. The earlier any problems can be recognized, the more likely it is they can be treated effectively.

Neuroblastoma survivors are at risk, to some degree, for several possible late effects of their treatment. It’s important to discuss what these possible effects might be with your child’s medical team.

The risk of late effects depends on a number of factors, such as the specific cancer treatments the child received, doses of treatment, and age when getting the treatment. Late effects of treatment can include:

  • Heart or lung problems (from certain chemotherapy drugs or radiation therapy)
  • Slowed or decreased growth and development (especially after a stem cell transplant)
  • Bone damage or thinning of bones (osteoporosis)
  • Changes in sexual development and ability to have children (especially in girls)
  • Changes in intellectual function with learning problems
  • Development of second cancers, such as leukemia, later in life. These are not common, but they can occur.

There may be other possible late complications from treatment as well. Your child’s doctor should carefully review any possible problems with you before your child starts treatment.

Along with physical side effects, survivors of childhood cancer may have emotional or psychological issues. They also may have some problems with normal functioning and school work. These can often be addressed with support and encouragement. Doctors and other members of the health care team can also often recommend special support programs and services to help children after cancer treatment.

Long-term follow-up guidelines

To help increase awareness of late effects and improve follow-up care of childhood cancer survivors throughout their lives, the Children’s Oncology Group (COG) has developed long-term follow-up guidelines for survivors of childhood cancers. These guidelines can help you know what to watch for, what type of screening tests should be done to look for problems, and how late effects can be treated.

It is very important to discuss possible long-term complications with your child’s health care team, and to make sure there is a plan in place to watch for these problems and treat them, if needed. To learn more, ask your child’s doctors about the COG survivor guidelines. You can also download them for free at the COG website: The guidelines are written for health care professionals. Patient versions of some of the guidelines are available (as “Health Links”) on the site as well, but we urge you to review them with a doctor.

For more about some of the possible long-term effects of treatment, see our document Children Diagnosed With Cancer: Late Effects of Cancer Treatment.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: March 14, 2014 Last Revised: January 22, 2016

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