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Long-Term and Late Effects For Cancer Survivors

Blood cancer survivors don't always have serious long-term or late effects of treatment. For those who do, some long-term effects, such as fatigue, can linger for months or years after therapy. Late effects, such as medical conditions like heart disease and other cancers, don't appear until years after treatment ends. Effects can range from mild to severe.

Talk with your doctor about possible long-term and late effects. Your risk for developing long-term or late effects can be influenced by your:

  • Treatment type and duration
  • Age at the time of treatment
  • Gender
  • Overall health

Long-term and late effects can include:

Cognitive effects

Cancer treatments such as chemotherapy and radiation therapy can cause problems with mental functions, such as concentration, memory and the ability to multitask (to keep track of and do different tasks at the same time). These effects are sometimes referred to as "chemo brain" or brain fog.

Psychological effects

You might experience long-term psychological effects after treatment ends, including depression or post-traumatic stress disorder.

Physical effects

Chemotherapy and Other Drug Therapies

Depending on your treatment type and length and your individual risk factors, including genetics and overall health, you may be at risk for:

  • Heart conditions/damage (chronic heart failure, heart muscle injury)
  • Thyroid problems
  • Lung damage (scarring, inflammation, acute respiratory distress syndrome, lung failure)
  • Infertility, including premature ovarian failure and premature menopause in women and low testosterone levels and sperm counts in men
  • Osteoporosis (low bone density)
  • Hearing loss
  • Cataracts
  • Secondary cancers, such as acute myeloid leukemia and myelodysplastic syndromes
  • Peripheral neuropathy
  • Impaired immune system function

Radiation Therapy

Radiation therapy uses ionizing radiation to kill cancer cells. For this reason, some cancer survivors who have had radiation therapy to the head and neck can develop:

  • Hypothyroidism or hyperthyroidism
  • Hearing loss
  • Vision problems such as cataracts or glaucoma
  • Dental abnormalities, such as dry mouth or cavities
  • Brain or thyroid cancer
  • Osteoporosis (low bone density)

Radiation therapy to the chest can cause:

  • Lung damage (scarring, inflammation, breathing difficulties)
  • Heart damage (scarring, inflammation, coronary heart disease)
  • Osteosarcoma (bone cancer)
  • Breast cancer
  • Thyroid cancer
  • Hypothyroidism or hyperthyroidism

Women under age 30 who had radiation to the breast area are at risk for developing breast cancer 15 to 20 years after treatment. Women treated before age 21 have a significantly greater risk than older women and should have yearly mammograms and twice-yearly clinical breast exams, starting 10 years after treatment.

Radiation therapy can also affect fertility for both men and women. Total body irradiation for individuals undergoing a hematopoietic stem cell transplant can cause ovary or testes failure, leading to fertility issues. High-dose radiation to the spleen can increase the risk of developing repeated bacterial infections.

Effect on Daily Activities

Cancer treatment's cognitive, psychological and physical effects might affect your everyday activities. Support and help are available for cancer patients and survivors, who may face:

  • Job discrimination
  • Difficulty getting health or life insurance
  • Financial issues
  • Relationship or social problems
  • Lack of follow-up care

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