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How does being a cancer survivor have an impact on my health?
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Cancer survivors have a variety of post-treatment health experiences. Although most survivors feel well, ongoing side effects -- called long-term effects -- linger in some people. Other survivors develop late effects, which are new side effects that arise months or years after the completion of treatment.
Long-term and late effects can result from any of the main types of cancer therapy: surgery, radiation, chemotherapy and hormonal therapy. Examples of some documented long-term and late effects are shown in the tables below. Not every cancer survivor experiences long-term or late side effects. If you are having health problems, it is important to discuss your symptoms with your doctor or nurse.
Possible Long-term and Late Effects of Surgery among Survivors of Adult Cancers1
| Procedure |
Possible Long-Term and Late Effects |
| Any Procedure |
Pain, cosmetic changes, psychosocial issues, impaired wound healing |
| Surgery involving neurologic structures (brain, spinal cord) |
Impairment of cognitive function, motor sensory function, vision, swallowing, language, bowel and bladder control |
| Head and neck surgery |
Difficulties with verbal communication, swallowing, and breathing; cosmetic changes; damage to muscles affecting movement |
| Removal of lymph nodes |
Lymphedema, retrograde ejaculation in testicular cancer |
| Abdominal surgery |
Risk of intestinal obstruction, hernia, altered bowel function |
| Pelvic surgery |
Sexual dysfunction, incontinence, hernia, risk of intestinal obstruction |
| Removal of spleen |
Impaired immune function, increased risk of sepsis, hernia |
| Amputation; limb-sparing procedures |
Functional changes; cosmetic deformity; psychosocial impact; accelerated arthritis in other joints; postsurgical, phantom, and/or neuropathic pain |
| Lung resection |
Difficulty breathing, fatigue, generalized weakness |
| Prostatectomy |
Urinary incontinence, sexual dysfunction, poor body self-image |
| Oophorectomy |
Premature menopause and infertility |
| Orchiectomy |
Infertility, testosterone deficiency |
| Ostomy |
Bowel function, constipation, nausea, vomiting, loss of appetite, fatigue, poor body self-image |
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1 Institute of Medicine. 2005. From Cancer Patient to Cancer Survivor: Lost in Translation. Washington, DC: The National Academies Press: 74.
Possible Late Effects of Radiation Therapy, Chemotherapy, and Hormonal Therapy among Survivors of Adult Cancers2
| Organ System/Tissue |
Possible Radiation Therapy Long-Term and Late Effects |
Chemotherapy/Hormonal Therapy |
| Possible Long-Term and Late Effects |
Agent Responsible |
| All Tissues |
Second cancers |
Second cancers |
Steroids, alkylating agents, nitrosoureas, topoisomerase inhibitors, anthracyclines |
| Bone and soft tissue |
Atrophy, deformity, fibrosis, bone death |
Bone death and destruction, risk of fractures |
Steroids |
| Cardiovascular (heart) |
Scarring or inflammation of the heart, coronary artery disease |
Inflammation of the heart, congestive heart failure |
Anthracyclines, high-dose cyclophosphamide, cisplatin, Herceptin, taxanes |
| Oral health |
Dental caries, dry mouth, trismus |
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| Endocrine-pituitary (gland) |
Various hormone deficiencies |
Diabetes |
Steroids |
| Endocrine-thyroid (gland) |
Low, thyroid function, thyroid nodules |
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| Endocrine-gondal (gland) |
Sterility
Men: testosterone deficiency
Women: premature menopause |
Sterility
Men: testosterone deficiency
Women: premature menopause |
Alkylating agents, procarbazine hydrochloride, nitrosoureas |
| Gastrointestinal (stomach) |
Malabsorption, intestinal stricture |
Motlility disorders |
Vinca drugs |
| Genitourinary |
Bladder scarring, small bladder capacity |
Hemorrhagic cystitis |
Cyclophosphamide, ifosfamide, transplant therapy |
| Hematologic (blood) |
Low blood counts, myelodysplastic syndrome, and acute leukemia |
Myelodysplastic syndrome and acute leukemia |
Alkylating agents, nitrosoureas, topoisomerase inhibitors, purine analogs, and high-dose therapy with autologous transplantation |
| Hepatic (liver) |
Abnormal liver function, liver failure |
Abnormal liver function, cirrhosis, liver failure |
Methotrexate, carmustine (BCNU) |
| Immune system |
Impaired immune function, immune suppression |
Impaired immune function, immune suppression |
Steroids, anti-thymocyte globulin (ATG), methotrexate, rithuximab, alemtuzumab, purine analogs, and any high-dose therapy with autologous transplantation |
| Lymphatic (lymph system) |
Lymphedema |
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| Nervous system |
Problems with thinking, learning, memory; structural changes in the brain; bleeding into the brain |
Problems with thinking, learning, memory; structural changes in the brain; paralysis; seizure
Numbness and tingling, hearing loss
Numbness and tingling |
Methotrexate, multiagent chemotherapy, bortezomib
Cisplatin
Vinca alkaloids, taxanes, oxaliplatin |
| Ophthalmologic (eye) |
Cataracts, dry eyes, visual impairment |
Cataracts |
Steroids |
| Pulmonary (lungs) |
Lung scarring, decreased lung function |
Lung scarring, inflammation |
Bleomycin sulfate, carmustine (BCNU), methotrexate |
| Renal (kidney) |
Hypertension, impaired kidney function |
Impaired kidney function, delayed-onset renal failure |
Cisplatin, methotrexate, nitrosoureas |
2 Institute of Medicine. 2005. From Cancer Patient to Cancer Survivor: Lost in Translation. Washington, DC: The National Academies Press: 72-73.
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