After Treatment for Childhood Cancer

During cancer treatment, most families are mainly concerned about the daily aspects of getting through treatment and beating the cancer. After treatment, the concerns tend to shift toward the long-term effects of the cancer and its treatment, and concerns about the cancer coming back.

It is certainly normal for families to want to put the cancer and its treatment behind them and to get back to a life that doesn’t revolve around cancer. But it’s important to realize that close follow-up care is a central part of this process that offers children the best chance for recovery and long-term survival.

Once treatment is finished, the health care team will set up a follow-up schedule. For many years after treatment, it is very important that children have regular follow-up exams with the cancer care team. As time goes by, the risk of the cancer coming back goes down. Doctor visits might be needed less often, but they are still important because some side effects of treatment might not show up until years later.

Because of major advances in treatment, more children treated for cancer now survive into adulthood. But treatments might affect children’s health later in life, so watching for health effects as they get older has become more of a concern in recent years. The earlier any problems are recognized, the more likely it is they can be treated effectively.

Childhood cancer survivors are at risk, to some degree, for several possible late and long-term effects of their cancer treatment. It’s important to discuss what these possible effects might be with your child’s medical team. The risks for each child depend on a number of factors, such as the type of cancer, the specific cancer treatments used, the doses of cancer treatment, and the child’s age at the time of treatment. It’s very important to discuss possible late side effects with your child’s health care team, and to make sure there is a plan to watch for these problems and treat them, if needed. Some of the possible late effects of cancer treatment include:

• Heart or lung problems (due to certain chemotherapy drugs or radiation therapy to the chest area)
• Slowed or delayed growth and development (in the bones or overall)
• Changes in sexual development and ability to have children
• Learning problems
• Increased risk of other cancers later in life

To learn more about the possible specific long-term side effects for a particular type of cancer, see our document on that specific type of cancer.

To help raise awareness of late effects and improve follow-up care of childhood cancer survivors throughout their lives, the Children’s Oncology Group (COG) has developed long-term follow-up guidelines for survivors of childhood cancers. These guidelines can help you know what to watch for, what type of screening tests should be done to look for problems, and how late effects can be treated.

To learn more, ask your child’s doctors about the COG survivor guidelines. You can also read them on the COG website at www.survivorshipguidelines.org. The guidelines are written for health care professionals. Patient versions of some of the guidelines are available (as “Health Links”) on the site as well, but we urge you to discuss them with your doctor.

For more about some of the possible long-term effects of treatment, see Late Effects of Childhood Cancer Treatment.