Late Effects of Cancer - Types and Therapies That Result in Cancer

Introduction:

After a patient's cancer treatment has concluded, late effects are side effects that persist. Years after receiving cancer treatment, survivors may still experience side effects. There is a high chance of long-term negative effects in many cancer survivors. After therapy, some side effects may appear months or even years later. An essential component of cancer survival treatment is assessing and managing late effects.

What Are the Types of Late Effects Seen in Cancer Survivors?

Problems From Surgery: Late side effects of surgery depend on the type of cancer and the part of the body that was operated on.

• Hodgkin's lymphoma survivors, especially those diagnosed before 1988, often had their spleens removed. An essential component of the immune system is the spleen. Removal increases the risk of infection.

• Survivors of soft tissue and bone cancer can have lost all or part of a limb. This can have physical and emotional effects. One example is phantom limb pain. This is a pain in an amputated limb, even though it is no longer present. Rehabilitation helps the body cope with changes that occur with treatment.

• Individuals who have undergone surgery or radiation therapy to remove lymph nodes may get lymphoedema. Little organs with a bean form called lymph nodes aid in the defense against infections. Lymph fluid accumulates to cause swelling and pain in lymphoedema.

• People who have had certain pelvic or abdominal surgeries may not be able to have children. This is called infertility. Learn more about infertility issues and maintaining fertility in both men and women.

Heart Problems: Both chemotherapy and radiation therapy to the chest can cause heart problems. Some survivors may be at higher risk. This includes people such as:

• Treated for Hodgkin's lymphoma as a child.

• Over 65 years old.

• Received a higher dose of chemotherapy.

• Receiving certain medications such as Trastuzumab or Doxorubicin.

Below is a list of common heart conditions. Call their doctor right away if the patient experiences any of the following symptoms:

• Chronic heart failure (CHF) is a weakening of the heart muscle. Symptoms include shortness of breath, dizziness, and swelling of the limbs.

• Coronary artery disease is a type of heart disease. It is more common in patients who have received high-intensity radiation therapy to the chest. Symptoms include chest pain and shortness of breath.

• An arrhythmia is an irregular heartbeat. Symptoms include lightheadedness, chest pain, and shortness of breath.

Examples of medications that can harm the heart include:

• Trastuzumab.

• Doxorubicin.

• Daunorubicin.

• Epirubicin.

• Cyclophosphamide.

• Osimertinib.

Hypertension: This is also called high blood pressure. It can also occur with CHF (see above). Or it could be another symptom. If the patient has high blood pressure, the patient’s doctor may want to monitor the patient’s blood pressure more closely during cancer treatment. Accelerated hypertension is a sudden, sharp rise in blood pressure. Organ damage is common. Therefore, it is important to seek immediate medical attention.

Some cancer drugs can cause high blood pressure. Examples of these drugs are:

• Bevacizumab.

• Sorafenib.

• Sunitinib.

Lung Problems: Chemotherapy and radiation therapy to the chest can damage the lungs. Cancer survivors who receive both chemotherapy and radiation therapy may be at increased risk of lung injury. People with lung disease and older people are more likely to have lung problems.

Drugs that can cause lung damage include:

• Bleomycin.

• Carmustine.

• Methotrexate.

The following are potential long-term lung effects:

• A modification in the lungs' functionality.

• Lungs' lining is becoming thicker.

• Lungs that are inflamed.

• Breathing challenges.

Endocrine System Problems: The endocrine system may be affected by specific cancer therapies. This system consists of the organs and glands responsible for producing hormones as well as eggs and sperm. Regular blood tests to evaluate hormone levels are necessary for cancer patients at risk for hormone alterations from therapy.

• Menopause: A woman may experience menopausal symptoms as a result of several cancer therapies. These remedies consist of:

  • Surgery to remove a woman’s ovaries (oophorectomy).

  • Chemotherapy.

  • Hormone therapy.

  • Radiation therapy to the pelvic area.

Menopause symptoms brought on by cancer therapy may be more severe than those of menopause naturally. This occurs as a result of how rapidly hormone levels drop. These signs include:

• Changes in mood or sexual desire.

• Hot flashes.

• Osteoporosis.

• Bladder control problems.

• Hormone Problems for Men: Men may encounter side effects from some therapies that resemble menopausal symptoms. These include testicular removal surgery or hormone treatment for prostate cancer. Some signs might be

  • Hot flashes.

  • Osteoporosis.

  • Changes in libido.

• Infertility: Treatments that affect the reproductive and endocrine systems increase the risk of infertility. Infertility means the inability to conceive or have children. Infertility due to cancer treatment may be short-lived. But sometimes, it is permanent.

• Hormone Problems From Head and Neck Radiation Therapy: Hormone levels can be decreased by radiation treatment to the head and neck. Thyroid gland alterations are also possible.

Bone, Joint, and Soft Tissue Problems: Chemotherapy, steroid drugs, or hormone therapy can cause bone loss and joint pain called osteoporosis. Immunotherapy can cause joint and muscle problems. These are called rheumatic problems. Physically inactive people may be at higher risk for these symptoms. Cancer survivors can reduce their risk of osteoporosis by:

• Avoid tobacco products.

• Eat foods rich in calcium and vitamin D.

• Get physically active.

• Limit alcohol intake.

Brain, Spinal Cord, and Nerve Problems: Chemotherapy and radiation therapy can cause long-term side effects on the brain, spinal cord, and nerves. These include:

• Hearing loss is caused by chemotherapy in large doses, particularly by chemicals like cisplatin.

• High radiation doses to the brain increase the risk of stroke.

• Symptoms of the nervous system include peripheral neuropathy or damage to the nerves outside the brain and spinal cord.

Learning, Memory, and Attention Difficulties: Both adults and children may experience cognitive issues as a result of chemotherapy and high-dose radiation given to the head and other sections of the body. Information processing issues give rise to cognitive disorders. The patient has to speak with their physician if they encounter any of these issues.

Issues With Eyesight, Dental Health, and Oral Hygiene: Depending on the therapies they underwent, cancer survivors may experience issues with their teeth, gums, or eyes, as well as:

• Chemotherapy may have an impact on tooth enamel and raise the chance of developing long-term dental issues.

• Tooth development may be altered by high radiation doses administered to the head and neck. Additionally, it can lead to gum disease and reduce salivation, which results in a dry mouth.

• Eye issues might be more likely if the patient uses steroids. This includes cataracts, an eye clouding that impairs vision.

Digestive Issues: Surgery, radiation therapy, and chemotherapy all have the potential to alter how someone digests food. Abdominal surgery or radiation therapy can result in intestinal issues, tissue scarring, and chronic discomfort. Chronic diarrhea in certain survivors may make it harder for the body to absorb nutrition.

Emotional Challenges: Cancer survivors frequently experience a range of feelings, both good and bad:

• Feel safe and grateful for being alive.

• Fear of repetition.

• Fury.

• Hindrance.

• Depression.

• Fear.

• Feel lonely.

Secondary Cancers: Perhaps a new primary cancer has emerged. It could manifest as a side effect of earlier cancer therapies, including radiation and chemotherapy. Or the cancer may have originated in one area of the body and then spread there. Radiation and chemotherapy treatments can potentially harm the stem cells in the bone marrow. Both myelodysplasia and acute leukemia become more likely as a result. The normal components of the blood are either not created or are defective in myelodysplastic syndrome, a kind of blood cancer.

Fatigue: A persistent sense of physical, emotional, or mental exhaustion is referred to as fatigue. It is the most typical adverse reaction to cancer therapy. After finishing treatment, some cancer survivors continue to feel tired for months or even years.

Which Cancer Therapies Result in Long-Term Side Effects?

Any of the primary therapy modalities can have long-term impacts on cancer patients. Chemotherapy, hormone replacement treatment, radiation, surgery, targeted therapy, and immunotherapy are some of these. Newer cancer therapies have been discovered to have long-term side effects when they become accessible.

Chemotherapy:

Side effects are as follows:

• Dental issues.

• Premature menopause.

• Loss of hearing.

• Heart issues.

• Risk of developing more malignancies.

• Infertility.

• Taste loss.

• Lung disease.

• Nerve injury.

• Memory problems.

• Osteoporosis.

• Difficulties with digesting.

• Decrease in lung capacity.

Radiation Therapy:

Side effects are as follows:

• Decayed teeth and cavities.

• Premature menopause.

• Vascular and cardiac issues.

• Hypothyroidism.

• Risk of developing more malignancies.

• Risk of stroke.

• Rising Infertility.

• Digestive issues.

• Lung condition.

• Lymphedema.

• Memory problems.

• Osteoporosis.

Surgery:

Side effects are:

• Lymphedema.

Hormone Therapy:

Side effects are as follows:

• Clots of blood.

• Bursts of heat.

• Increased chance of getting additional malignancies.

• Signs of menopause.

• Osteoporosis.

• Negative sexual consequences.

Immunotherapy:

Side effects are:

• Joint or muscular issues.

Targeted Therapy:

Side effects are as follows:

• Bleeding clots.

• Vascular and heart issues.

What Are the Long-Term Implications of Pediatric Cancer Treatment?

Many of the late adverse effects that might occur after cancer therapy in adults may occur in people who received cancer treatment as children. Those who survived childhood cancer may be at risk for more long-term negative effects. This is due to the rapid growth of children's bones, tissues, and organs. Some of these long-term negative effects are seen by childhood cancer survivors:

• Heart issues, such as an increased chance of a heart attack.

• Blood vessel issues that increase the risk of stroke.

• Breathing difficulties can result from lung conditions.

• Liver issues.

• Kidney issues.

• Cataracts.

• Bone issues, such as osteoporosis, cause bone thinning and joint discomfort.

• Delayed bone development is the cause of short height.

• Obesity.

• Infertility

• Memory problems and learning challenges

• Loss of vision.

• Loss of hearing.

• Thyroid issues.

• Increased chance of developing other malignancies.

• Nerve injury.

Conclusion:

Patients who have overcome cancer are prepared to resume their normal lives. However, the patient's quality of life may be impacted by disease-related side effects or rigorous treatment regimens. Some may be passing, while others could be permanent.