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Most children will not have any serious long-term problems after having treatment for cancer. However, it is very important for them to attend a follow-up clinic to check for any problems that may occur.
Certain treatments may affect puberty and fertility. These are:
Your child will be checked for signs of puberty. If this appears to be delayed, hormone replacement therapy may be needed so that puberty can occur.
Some treatments for cancer can cause problems with fertility. It can be very distressing to think that your child may not be able to have children in the future. Your child may also find this difficult to cope with, either now or in the future as they move toward adulthood.
For children who have already reached puberty, it can be difficult to know whether cancer treatment has affected fertility until they are old enough for hormone tests to be carried out. This will be discussed at follow-up clinics.
If fertility is likely to be a problem, older boys may be given the option of sperm banking before they start treatment. The hospital staff can tell you more about this.
Cancerbackup has a booklet about sex and fertility for teenagers and young people. Order the booklet online.
Radiotherapy can have important effects on growth and development. It may affect growing bones: for example, if radiotherapy is given to the spine, your child may not grow quite as tall as expected. If radiotherapy is given to a leg, then that leg may be shorter than the other.
Radiotherapy to the brain may affect the production of growth hormone by the pituitary gland. The pituitary gland produces hormones and helps to regulate growth and development from childhood to adulthood. If your child does not produce enough growth hormone, they will not grow normally and may need treatment with man-made growth hormone.
At the follow-up clinic, your child will be regularly weighed and measured. If their growth has been affected, tests will be done to see if growth hormone replacement is needed.
Certain treatments can affect the heart and lungs, and the effects may not be seen for some time after treatment has ended. These treatments include some chemotherapy drugs and radiotherapy. If your child is at risk of these problems they will be regularly followed up with echocardiograms (heart ultrasound). Sometimes it is necessary to do special tests on the lungs (lung function tests).
These can occur after some types of treatment for childhood cancer but fortunately they are not usually severe. Removal of one kidney as part of treatment does not usually cause any problems because the remaining kidney can make up for the one removed.
Certain chemotherapy drugs can cause problems for the kidneys. If your child has had these drugs, their doctor will arrange checks on their kidneys from time to time. Children whose kidneys are working well at the end of treatment should not develop problems in the future.
Following treatment, most children are able to continue with normal education and the development of their ability to think and understand (intellectual development) is not affected. However, some children, especially children treated for brain tumours, may develop learning difficulties and need to have special help at school. The extent of these difficulties will depend on the age of your child when they were treated, and the treatment they had.
Some children will need a statement of special educational needs to provide the necessary help in the school environment. You can discuss this with the doctor who can give details of treatment and, if necessary, contact the school or education authority.
A very small number of children who are cured of cancer go on to develop another, different, cancer later on in life. There are two main reasons for this. Firstly, some families have an inherited risk factor for cancer, although this is rare. Secondly, some cancer treatments can themselves increase the risk of other cancers. Your child’s doctor will be able to discuss any worries you may have about this.
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