Your child should visit his or her pediatrician or primary care physician at least once a year for a complete physical exam and any additional needed tests. Your oncologist should also regularly examine your child.
Regular doctor visits are encouraged to:
- enable doctors to assess the full effect of therapy
- detect and treat disease recurrence
- identify and manage long-term and late effects of treatment
Your pediatrician should recommend a schedule for having your child's learning skills assessed. If your child appears to be experiencing learning disabilities, special education methods can help.
Coordination between your child's pediatrician and oncologist is important for the best care possible. Some treatment centers offer comprehensive follow-up care clinics for childhood cancer survivors. To find one near you, visit The Pediatric Oncology Resource Center.
Long-Term and Late Effects of Treatment
Some side effects of cancer treatment, such as fatigue, can linger for months or years after therapy. Some medical conditions like heart disease and other cancers may not appear until years after treatment ends. Long-term and late effects can impact your child's physical, mental and cognitive (brain function) health.
Most childhood survivors of lymphoma don't develop significant long-term or late effects of treatment. However, for some patients the effects can range from mild to severe.
Long-Term and Late Effects of Chemotherapy
Children treated for lymphoma may be at increased risk for:
- growth delays
- thyroid dysfunction
- hearing loss
- a secondary cancer
Some long-term and late effects become evident with maturation (puberty), growth and the normal aging process. Early intervention and healthy lifestyle practices (not smoking, good nutrition, exercise, regular screenings and follow-up) help.
Long-Term and Late Effects of Radiation Therapy
Girls (as well as women under age 30) who had radiation to the breast area are at risk for developing breast cancer 15 to 20 years after treatment. Male survivors of childhood cancer are at risk for developing second cancers, but they don't have as high a risk for developing breast cancer as female childhood cancer survivors do.
Girls who had radiation therapy in the chest area (mediastinal) should:
- perform monthly self-breast exams
- get a baseline mammogram at age 25 to 30 or 10 years after radiation therapy
- have an annual clinical breast exam
- have a mammogram every two to three years, depending on breast tissue density
Both girls and boys who've undergone mediastinal radiation therapy should have baseline testing for heart function. This should be followed by testing every three to five years after treatment or more regularly if any abnormalities are found.
More to Explore
- Managing long-term and late effects
- Follow-up care and screening schedules
- Download or order The Leukemia & Lymphoma Society's (LLS's) free fact sheet Long-Term and Late Effects of Treatment in Children
Returning to School
Learning disabilities can begin during treatment or appear months or years after. Educate family members, friends, school personnel and healthcare providers about your child's possible long-term and late effects of treatment. Talk with teachers about your child's needs before he or she returns to school. Work with your child's teachers and medical providers to develop a program tailored to his or her needs that features baseline testing, special accommodations and long-term planning.
More to Explore
- Returning to school after illness
- LLS's Trish Greene Back to School Program
- Download or order LLS's free booklet Learning and Living with Cancer: Advocating for Your Child's Educational Needs
Researchers are working to improve their understanding of long-term and late effects and to create guidelines for follow-up care. They're also seeking to understand how factors like aging and social and economic status influence long-term and late effects. The Leukemia & Lymphoma Society is currently funding an initiative at Children's Hospital of Philadelphia to discover and eliminate the causes of cancer treatment's late effects.