Late effects of chemotherapy although not very common in many cases are quite severe. These side effects take some time to show up after the treatment begins. It usually occurs after five years from the time the cancer is detected and the treatment begins. The type of late effects and the time when it begins varies from person to person. The late effects need to be treated effectively and it is also an important part of cancer care.

Any type of cancer treatment can cause late effects. Some of the most common late effects arising from chemotherapy are:

• Lung problems: In most cases when chemotherapy is combined with radiation therapy for the chest it causes injury to the lungs. For example, a patient who undergoes a bone marrow transplant combining chemotherapy and radiation have a high risk of causing damage to the lungs. The drugs that might cause damage to the lungs include, blenoxane, becenum, carmubris, BiCNU to name a few. The common lung problems that patients might experience are, difficulty in breathing, lungs inflammation, change in lung functioning, thickening in the lining of lungs.
• Hormone problems: Chemotherapy might change the level of hormones among cancer patients. As a late effect it might damage the ovaries in woman which might result in sexual dysfunction, osteoporosis, hot flashes and even early menopause. Apart from this it might also result into infertility in both men and women.
• Joint and bone pain or problems in the soft tissues: A very common late side effect observed among cancer patients is osteoporosis. As per a study bone and join pain is more frequently occurred in cancer survivors than the general population in U.S. Cancer survivors especially breast and prostate cancer survivors and the ones suffering from childhood leukemia can lower the risk of osteoporosis by talking calcium rich foods, indulging in regular physical activities, quitting smoking and limiting the intake of alcohol.
• Nerve, brain and spinal cord problems: High doses of chemotherapy can lead to hearing loss, low memory and attention spans or even learning disorders. Most of these disorders are commonly experienced in children but adults could also face with these disorders.
• Dental problems: Regular dentists check-ups are recommend for all cancer patients as chemotherapy might harm the tooth enamel and might also lead to long term dental problems.
• Vision problems: Steroids in some cases can cause eye problems such as cataracts.
• Problems with digestion: Chemotherapy may cause digestive problems among the patients. It is best to contact a dietitian or nutritionist who can instruct the patients about the food that they can have and which would also fulfill all the nutritional requirements for a healthy body.
• Liver problems: Some drugs such as thioguanine and methotrexate can cause damage to the liver.
• Emotional difficulties: Cancer is one of the most difficult times experienced in the life of cancer patients. Emotional difficulties can be experienced by the patients even after a few years from the treatment because in some cases patients experience loss of memory, depression, fear, anger, isolation and anxiety, which takes a lot of time to recover and also for the society to accept them in their normal self.Returning to school or work place, copying with your body image as well as maintaining interpersonal relationships take time in most cases to rebuild.
• Cancer reappearance: In some cases, even after the cancer gets healed completely it reappers in a different form from the original cancer. As per National Cancer Institute there is a great risk of developing a new cancer among cancer survivors with 14% approximate chances. This development could also be a result of the chemotherapy or radiation treatments that the patients underwent.
• Apart from this, fatigue, pain anemia, lack of physical strength are also some of the late effects which remain for quite some time even after the treatment is over.

Because of the late effects of chemotherapy many cancer patients undergo follow up care to make sure that the effects of chemotherapy or another cancer of a different kind does not reoccur. Regular yearly examination and testing is required to be done by the patients to avoid the late effects as much as possible.