The benefits ofchemotherapyfar outweigh the potential risks, but there are long-term side effects. Many people are familiar with the short-term side effects such as hair loss and nausea, but some side effects may persist or arise months to years after treatment has been completed.
When it comes to long-term side effects, keep in mind that everyone is different. Some people may have several of these side effects, while many will have none. Side effects also vary considerably depending on the particular chemotherapy medications that are used.
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Heart Damage
Chemotherapy can cause cardiac effects early in treatment, but in some cases, the effects may not show up until much later.
One notable example is heart damage following treatment with Adriamycin (doxorubicin). With this drug, a possible long-term side effect is weakening of the heart muscle, resulting in heart failure (a decreased ability to pump blood through the body). Symptoms may include increasing shortness of breath, fatigue, and swelling of the feet and ankles. If you have been treated withAdriamycin, your healthcare provider may recommend aMUGA scanto monitor your heart.
Other cancer treatments, such asradiation therapyto the chest area, may cause damage to the heart muscle as well. For example, left-sided radiation for lung cancer or breast cancer may also affect the heart and damage coronary arteries.
If you will be having both chemotherapy and radiation therapy to your chest, your radiation oncologist might suggest respiratory gating, a technique that can reduce the amount of radiation to your heart.
Fatigue
During chemotherapy, most people experiencefatigue, and a third of people continue to experience fatigue formonths to yearsafter chemotherapy is completed. It is important to discuss this with your healthcare provider—many causes of fatigue are treatable.
Chemobrain
“Chemobrain,” a constellation of symptoms that includeproblems with memory and concentration, has been recognized as a long-term side effect of chemotherapy. The effects can include symptoms such as problems with short-term memory (losing your car keys), difficulty multi-tasking, and impaired concentration, especially when you are tired.
Coping can involve strategies like doing one thing at a time or slowing down. In most cases, chemobrain symptoms improve over time.
Infertility
Loss of fertility after chemotherapy is primarily a concern for younger people with cancer. Infertility following treatment varies with the dose and type of chemotherapy medications, and it doesn’t affect everyone.
If you believe you may want to have children after treatment (for both men and women), talk to your healthcare provider about the options available to you before you start treatment.Methods such as preserving sperm, eggs, or embryos have worked for many people.
Peripheral Neuropathy
Neuropathy from chemotherapy often causes a sensation of numbness and burning in the feet and hands, as well as constipation. This is a common side effect after chemotherapy. A history of diabetes, alcoholism, or malnutrition increases the risk. While neuropathy may sometimes improve in time, it can also be a permanent late effect of chemotherapy.
Some drugs that can cause this side effect in up to a third of people include Taxotere (docetaxel) and paclitaxel, Other medications, such as Platinol (cisplatin), Oncovin (vincristine), and Novelbine (vinorelbine), can also result in neuropathy.
Hearing Loss
One of the most common long-term side effects of Platinol (cisplatin), a medication used for many cancers including lung cancer, isototoxicity(damage to the structures of the ear). Other medications may also cause hearing loss and tinnitus (ringing in the ears).
Skeletal Effects
Osteoporosis(thinning of the bones) is the most common late effect of chemotherapy. Most chemotherapy drugs cause accelerated bone loss. Cancer and cancer treatment may also cause changes in diet, which can amplify the problem. The greatest concern over the long run is the risk of fractures due to bone loss.
Chemotherapy has also been associated with osteomalacia, which is bone loss related toa deficiency of vitamin D.
Hormone therapies for women with breast cancer and men with prostate cancer can add to the risk. Many healthcare providers recommend getting a baseline bone density measurement when beginning these therapies.
A class of medications that decrease the reabsorption of minerals from bone (promoting bone stability) calledbisphosphonates has been used in early stages of breast cancerin postmenopausal women. These medications are shown to modestly reduce the incidence of bone fractures down the line, and also to decrease the chances of having cancer spread to the bone.
Respiratory Effects
Chemotherapy can causepulmonary fibrosis(scarring of the lung) and decreased lung capacity in some people. This may be more pronounced when chemotherapy is combined with radiation therapy to the chest area.
Liver Effects
Many chemotherapy medications can cause hepatotoxicity (toxic damage to the liver). The liver has a remarkable potential to regenerate most of the time, as long as other damaging factors (such as excess alcohol intake) are avoided.
Kidney and Bladder Effects
Certain chemotherapy medications, such as cisplatin, can cause damage to the kidneys and bladder. This can result in a decreased ability of your kidneys to filter your blood.
Damage to the bladder can also occur and may be temporary or permanent. Symptoms of bladder irritation may include pain or urgency with urination, or blood in your urine.
Effect on the Eyes
Steroids are often given along with chemotherapy or for symptoms and side effects related to cancer. This can hasten the development ofcataractsin some people.
Secondary Cancer
Other medications used to treat lung cancer that may cause secondary cancer include Vepeid (etoposide) and Platinol (cisplatin).
The risk of secondary cancer developing is higher in people who develop cancer at a younger age and with cancers that have a high survival rate. For example, the risk of secondary cancer insurvivors of Hodgkin lymphomais substantial.
Coping With the Late Effects of Chemotherapy
Many of the larger cancer centers now provide cancer rehabilitation to help people maximize their new normal. The STAR program for cancer rehabilitation was designed specifically to address symptoms that prevent cancer survivors from enjoying the quality of life they otherwise can.
What Can You Do to Lower Your Risk of Long-Term Side Effects?
Until we know more about long-term survivorship issues following chemotherapy for adults, there are things you can do:
For childhood, adolescent, and young adult cancer survivors, long-term follow-up guidelines have been developed to address the long-term side effects and other survivorship issues.
SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Society of Clinical Oncology. Cancer.Net.Late Effects.Hu, M. et al.Cancer therapies and bone health.Current Rheumatology Reports. 2010. 12(3):177-85.Institute of Medicine. Cancer Survivorship Care Planning. Fact Sheet.National Cancer Institute.Chemotherapy and You: Support for People With Cancer. Chemotherapy Side Effects.
Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Society of Clinical Oncology. Cancer.Net.Late Effects.Hu, M. et al.Cancer therapies and bone health.Current Rheumatology Reports. 2010. 12(3):177-85.Institute of Medicine. Cancer Survivorship Care Planning. Fact Sheet.National Cancer Institute.Chemotherapy and You: Support for People With Cancer. Chemotherapy Side Effects.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Society of Clinical Oncology. Cancer.Net.Late Effects.Hu, M. et al.Cancer therapies and bone health.Current Rheumatology Reports. 2010. 12(3):177-85.Institute of Medicine. Cancer Survivorship Care Planning. Fact Sheet.National Cancer Institute.Chemotherapy and You: Support for People With Cancer. Chemotherapy Side Effects.
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