Treatment is Over – The Side-Effects are Not

Treatment is Over - The Side Effects are Not

Overweight woman getting dressed wearing jeans

Problems Related to Surgery:

  • Survivors of Hodgkin lymphoma, especially those diagnosed before 1988, often had their spleens removed. The spleen is a vital organ for the immune system. Removing it is linked with a higher risk of infections.

  • Survivors of bone and soft-tissue cancers may have lost part or all of a limb. This can cause physical and emotional effects. One example is phantom limb pain. This is feeling pain in the limb that was removed even though it is no longer there. Rehabilitation can help people cope with physical changes from treatment.

  • People who had radiation therapy or surgery to remove lymph nodes may develop lymphedema. Lymph nodes are tiny, bean-shaped organs that help fight infection. Lymphedema is when lymph fluid builds up and causes swelling and pain.

  • People who had certain surgeries in the pelvis or abdomen may not be able to have children. This is called infertility. Learn more about fertility concerns and preserving fertility in men and in women.

Heart Problems:

Both chemotherapy and radiation therapy to the chest can cause heart problems. Some survivors may have a higher risk. This includes those who:

  • Received treatment for Hodgkin lymphoma as a child

  • Are 65 and older

  • Received higher doses of chemotherapy

  • Received certain medicines, such as trastuzumab (Herceptin, Ogivri) and doxorubicin (Adriamycin, Doxil)

Below is a list of common heart conditions. Talk with your doctor right away if you have any of these symptoms:

  • Congestive heart failure (CHF) is weakening of the heart muscle. Symptoms include shortness of breath, dizziness, and swollen hands or feet.

  • Coronary artery disease is a type of heart disease. It is more common in those who had high doses of radiation therapy to the chest. Symptoms include chest pain and shortness of breath.

  • Arrhythmia is an irregular heartbeat. Symptoms include lightheadedness, chest pain, and shortness of breath.

Examples of drugs that can cause heart problems:

  • Trastuzumab

  • Doxorubicin

  • Daunorubicin (Cerubidine)

  • Epirubicin (Ellence)

  • Cyclophosphamide (Genoxal, Mitoxan)

  • Osemertinib (Tagrisso)

Ask your doctor if the treatments you are receiving can affect your heart. He or she may check your heart function and watch for damage during and after treatment. Your doctor may use a test called echocardiography, also called an echo. Other heart tests may include a physical examination, an electrocardiogram (EKG or ECG), and a multigated acquisition scan (MUGA) scan.

Hypertension. This is also called high blood pressure. It may happen along with CHF (see above). Or it may be a separate symptom. If you have high blood pressure, your doctor may watch it more closely during cancer treatment. Accelerated hypertension is when blood pressure suddenly and rapidly rises. It often causes organ damage. So it is vital to get medical help right away.

Some cancer drugs can cause high blood pressure. Examples of these drugs include:

  • Bevacizumab (Avastin, Mvasi)

  • Sorafenib (Nexavar)

  • Sunitinib (Sutent)

The risk of high blood pressure lowers once a person stops taking these drugs. But the long-term effects are not known. Survivors with increased risk for high blood pressure should work with their health care team to lower this risk. This may include testing blood pressure, losing weight, eating less salt, taking medicine, and being active.

Lung problems. Chemotherapy and radiation therapy to the chest may hurt the lungs. Cancer survivors who received both chemotherapy and radiation therapy may have a higher risk of lung damage. People who have had lung disease and older adults may have more lung problems.

Drugs that may cause lung damage include:

  • Bleomycin (Blexane)

  • Carmustine (Becenum, BiCNU, Carmubris)

  • Methotrexate (multiple brand names)

The late effects to the lungs may include:

  • A change in how well the lungs work

  • Thickening of the lining of the lungs

  • Inflammation of the lungs

  • Difficulty breathing

Hormone problems from head and neck radiation therapy. Radiation therapy to the head and neck area can lower hormone levels. It can also cause changes to the thyroid gland.

Bone, joint, and soft tissue problems. Chemotherapy, steroid medications, or hormonal therapy may cause thinning of the bones, called osteoporosis, or joint pain. Immunotherapy may cause problems in the joints or muscles. These are known as rheumatologic issues. People who are not physically active may have a higher risk of these conditions. It is critical to work with a professional who understands these issues and can create a safe and effective exercise program for you to avoid injury and get the best results. CETI Cancer Exercise Specialist to get a customized safe and effective exercise program catered to your specific needs and goals. 

Endocrine system problems. Some types of cancer treatments may affect the endocrine system. This system includes the glands and other organs that make hormones and make eggs or sperm. Cancer survivors at risk for hormone changes from treatment need regular blood tests to measure hormone levels.

  • Menopause. Many cancer treatments may cause a woman to have menopausal symptoms. These treatments include: surgery to remove a woman’s ovaries (oophorectomy), chemotherapy, hormone therapy, and radiation therapy to the pelvic area. 

  • Hormone problems for men. Some treatments may cause men to experience symptoms similar to menopause. These include hormone therapy for prostate cancer or surgery to remove the testicles. Symptoms may include: a change in sexual desire, hot flashes, weight gain, and osteoporosis. 

For both men and women, strength training and weight bearing exercises are critical in order to prevent osteoporosis as well as increase your basal metabolic rate to help you burn more calories per day. Cardiovascular training and a health diet can help you to combat hormone-related weight gain. Contact a CETI Cancer Exercise Specialist to get a customized safe and effective exercise program catered to your specific needs and goals. 

Brain, spinal cord, and nerve problems. Chemotherapy and radiation therapy can cause long-term side effects to the brain, spinal cord, and nerves. These include:

  • Hearing loss from high doses of chemotherapy, especially drugs like cisplatin (multiple brand names)

  • Increased risk of stroke from high doses of radiation to the brain

  • Nervous system side effects, including damage to the nerves outside the brain and spinal cord, called peripheral neuropathy. Peripheral neuropathy in the hands can affect your ability to perform fine motor skills while peripheral neuropathy in your feet can cause balance issues and pain with walking. 

CETI Cancer Exercise Specialist  can create a customized, safe, and effective exercise program catered to your specific needs and goals. Cancer survivors should have regular physical examinations and hearing tests after treatment to check for these effects. 

Learning, memory, and attention difficulties. Chemotherapy and high-dose radiation therapy to the head and other areas of the body may cause cognitive problems for adults and children. Cognitive problems occur when a person has trouble processing information. Talk with your doctor if you experience any of these issues.

Dental and oral health and vision problems. Cancer survivors may have dental and oral health and vision problems, depending on the treatments they received:

  • Chemotherapy may affect tooth enamel and increase the risk of long-term dental problems.

  • High doses of radiation therapy to the head and neck area may change tooth development. It can also cause gum disease and lower saliva production, causing a dry mouth.

  • Steroid medications may increase the risk of eye problems. This includes clouding of the eye that affects vision, called cataracts.

To watch for future problems, survivors should schedule regular appointments with a dentist and an ophthalmologist. An ophthalmologist is a doctor who specializes in treating eye conditions.

Digestion problems. Chemotherapy, radiation therapy, and surgery may affect how a person digests food. Surgery or radiation therapy to the abdominal area can cause tissue scarring, long-term pain, and intestinal problems. Some survivors may have chronic diarrhea that reduces the body’s ability to absorb nutrients.

A registered dietitian (RD) can help people with digestion problems get enough nutrients. 

Emotional difficulties. Cancer survivors often have various positive and negative emotions:

Cancer survivors, caregivers, family, and friends may also have post-traumatic stress disorder. This is an anxiety disorder. It may develop after living through a very frightening or life-threatening event, such as cancer diagnosis and treatment.

Each person’s post-treatment experience is different. For example, some survivors struggle with negative emotional effects of cancer. Others say that they have a renewed, positive outlook on life because of the cancer.

Secondary cancers. This may be a new primary cancer. It may develop as a late effect of previous cancer treatments, such as chemotherapy and radiation therapy. Or it may be the original cancer that has spread to other parts of the body from where it started. Exercise has been shown to reduce the risk of cancer recurrence in people with breast, colorectal, and prostate cancers.

CETI Cancer Exercise Specialist  can create a customized, safe, and effective exercise program catered to your specific needs and goals.

Chemotherapy and radiation therapy can also damage bone marrow stem cells. This increases the risk of either acute leukemia or myelodysplasia. Myelodysplasia is a blood cancer where the normal parts of the blood are either not made or are abnormal. Talk with your doctor about any new symptoms or side effects that you experience.

Fatigue. Fatigue is a constant feeling of physical, emotional, or mental tiredness. It is the most common side effect of cancer treatment. Some cancer survivors have fatigue for months or even years after finishing treatment. Exercise has been shown to minimize cancer-related fatigue.