Late effects of chemotherapy can be avoided with the help of a good follow up many years after the treatment. There are many side effects of chemotherapy, which disappear after the treatment. However, late effects are seen generally in children and they are the ones, which appear 5-10 years after the cancer is cured.

Most childhood cancer survivors live longer and thus their long-term health prospects and the probable late effects are a part of the clinical research.

These late effects depend on factors like-

• The type of cancer

• Location of the cancer
• Age of the patient during treatment
• Overall health before the cancer
• Genetic make-up

Some of the late effects are seen in certain parts of the body, especially in case of children when they grow into adulthood. Some of these late effects are-

Brain

Certain chemotherapies that are given intravenously or into the spine cause learning disabilities in children. These include cognitive impairments that show up within a few years of treatment. They are-

• Lower IQ scores

• Lower academic achievements
• Problems in memory and attention span
• Poor hand-eye coordination
• Slowed development over time
• Behavior problems

Eyes

Certain chemo drugs can be toxic to the eye and cause blurred vision, double vision, and glaucoma. These effects are temporary. Some late effects are-

• Dry eye

• Watery eye
• Constant irritation in the eye
• Discolored sclera
• Poor vision
• Light sensitivity
• Poor night vision
• Tumors on the eyelid
• Drooping eyelid

Ears

Certain chemotherapy drugs and antibiotics cause hearing loss especially with high-pitched sounds. Other late effects are-

• Ringing in the ears

• Trouble hearing when there is a high level of background noise
• Dizziness
• Hard, crusty earwax

Slow growth and short stature

Slow growth especially during childhood cancer treatment is quite common. A certain amount of catch-up could happen after the treatment. However, short stature or height remains permanent.

Hormones and reproductive systems

High doses of certain chemotherapy drugs affect the sperms and very high doses affect the hormones leading to erectile dysfunction and low count and viability of sperms.

This could be temporary or long lasting. There is less risk for boys who are treated before their puberty. For others, it is important to discuss the option of sperm banking with their doctor.

In females, ovaries could be affected due to chemotherapy and hence the ovulation and quality of egg is affected. The uterus also can be affected. Girls who are treated before puberty are at less risk. Some of the female hormones like estrogen are affected which are important for menstruation and fertility. Most of these issues can be treated although it is important to discuss them with the doctor before treatment.

The late effects also cause loss of sexual desire in both the sexes.

Heart

Heart disease could be a serious late effect of certain chemotherapies. The actual damage normally occurs during treatment; however, the effects show up many years later.

Chemotherapy drugs called anthracyclines cause damage the heart muscle or affect its rhythm.

Teeth

Chemotherapy that involves the teeth and jaw could cause late effects especially in children who are treated before five years of age. These late effects are-

• Small teeth

• Missing teeth or delayed tooth development
• Tooth enamel is abnormal and discolored
• Increased cavities
• Short roots of teeth leading to their early loss

Late effects of chemotherapy could lead to some health problems. However, it is important to realize that these effects are the result of an advanced life-saving treatment. Research is going on search for ways to reduce long-term effects. However, as of now, the gift of a normal life after treatment and a prolonged healthy survival would require to cope with some of the late effects of chemotherapy.