Cancer treatments such as chemotherapy can come with the risk of side effects. Doctors may prepare a person for the short-term side effects of chemotherapy, such as hair loss and fatigue, but there may also be long-term side effects.
Long-term side effects of chemotherapy may occur months or years after treatment. Long-term side effects, also called late effects, can vary depending on the person and treatment.
There is no exact timeline for when long-term side effects will appear or go away, and it may not always be possible to treat them if they do arise. Working with a doctor can help manage side effects where possible.
In this article, we examine the long-term side effects of chemotherapy. We also look at how long the side effects may last and how to prevent them.
Chemotherapy may cause the following long-term side effects:
Bone conditions
Chemotherapy drugs may contribute to bone conditions, including osteoporosis, a thinning of the bones.
As well as targeting cancerous cells, chemotherapy affects normal healthy cells such as those in the bones and marrow. This may accelerate bone loss, leading to broken bones. Along with causing dietary problems, chemotherapy may also make it possible for a person to have bone issues that result from vitamin D deficiency.
Other therapies may also affect the bones and bone density, such as hormonal therapies. If someone requires hormone therapy as part of their cancer treatment, they may experience bone density changes.
Doctors may recommend taking a baseline bone density measurement before starting therapies. This can help them identify treatment effects and recommend secondary treatments and precautions for those at a higher risk of bone loss.
Heart-related conditions
Chemotherapy may cause late side effects in the heart for some people, such as:
- irregular heartbeat or arrhythmia
- heart disease
- high blood pressure
- congestive heart failure
- valvular disease
- stroke
Heart-related side effects may be more pronounced if a person needs other therapies in the area, such as chest radiation therapy for lung cancer.
Lung conditions
Chemotherapy may cause lung conditions, such as:
- decreased lung capacity
- an increase in scar tissue called pulmonary fibrosis
- inflammation in the lungs
- trouble breathing or being short of breath
Lung problems may be more likely with specific drugs or when treatment targets the lung area, such as chest radiation therapy for lung cancer. Anyone with a high risk for other lung conditions should discuss all available treatment options with a doctor.
Cognitive problems
A group of cognitive issues, sometimes known as “chemo brain,” may occur as a late side effect of chemotherapy in some people. Cognitive issues may include problems with memory, concentration, or focus.
For example, a person may lose track of their keys and have difficulty doing daily activities that require multi-tasking or maintaining attention.
Other therapies such as radiation therapy for a brain tumor may cause similar cognitive problems.
Being aware of how cognitive symptoms affect a person may help them find ways to solve them. For example, a person who regularly loses their keys may take a picture with their phone each time they set their keys down, or they may choose to have someone else look after their keys when they get home.
Mental health conditions
Mental health conditions, such as anxiety, depression, and issues with body image, are common in cancer survivors. Research from 2018 notes that up to 20% of people with cancer experience depression, four times as common as the general population.
Dealing with long-term mental health conditions can be a challenge. However, working with a mental health professional may help a person find ways to manage their condition.
Hair loss
Hair loss is common with chemotherapy treatment. Research from 2017 notes that up to
A person may lose some or all of their hair during treatment. It typically starts to grow back after they complete treatment. However, in some people, the hair regrowth may have a different texture, grow differently, or have a different color.
Hair loss generally improves with time. In rare cases, such as when the person has to undergo intense chemotherapy for long periods, hair loss may be permanent.
Fatigue
Fatigue occurs with chemotherapy treatment but may also linger after treatment. If long-term fatigue is ongoing after chemotherapy, a person should talk to a doctor to explore possible reasons or options for managing symptoms.
Endocrine symptoms
Cancer treatments that affect the endocrine system may cause a person to have symptoms of menopause, such as:
- changes in sexual desire
- hot flashes
- issues with bladder control
- fewer menstrual periods
These symptoms may go away after cancer treatment. In younger females, menstrual periods may come back with time. For others, menopause may be permanent.
Males may also experience symptoms similar to menopause from cancer treatments for their prostate or testicles and therapies that affect the thyroid. They may experience a loss of sexual desire, erectile dysfunction, and hot flashes.
Infertility
Infertility may be a risk for some people receiving chemotherapy. A person should discuss infertility risks with a doctor before having chemotherapy treatment.
If a person plans on having children in the future, some procedures may make this a possibility. Methods such as preserving viable embryos or sperm may allow people to have children even if they become infertile.
Nerve damage
Nerve damage or peripheral neuropathy is a potential side effect of chemotherapy with various cancer types and treatments.
Other conditions may make peripheral neuropathy more likely, such as having other chronic conditions affecting the nerves.
A person should speak with a doctor to discuss their risk of nerve damage. Other risk factors for nerve damage may include diet, other conditions, and the type of chemotherapy drug.
Nerve damage may improve with time. For some people, it may be permanent.
Dental issues
Chemotherapy may affect the enamel of the teeth or how it forms. The long-term side effects of this may include an increased risk of dental issues such as cavities and sensitivity. Other cancer therapies may also affect the gums or lower saliva production.
Dental problems could be more likely in people receiving treatment for cancer of the head and neck.
Regular checkups with a dentist may help identify and treat problem areas. Some topical creams and toothpaste may help with tooth sensitivity.
There is no set timeline on side effects from chemotherapy. Chemotherapy will affect each person differently.
Side effects may appear during therapy and can last long after therapy is over. In some cases, long-term chemotherapy side effects may not occur until months or years after treatment.
Some chemotherapy complications may be permanent, while others may subside with time. Doctors may recommend treatments to help manage complications and discuss the risk of permanent complications.
It is not always possible to prevent long-term side effects from chemotherapy. There is no way to tell precisely how therapy will affect any given individual.
Doctors may discuss the risk of long-term effects or permanent issues with a person to help them select the most suitable drugs and therapies.
Chemotherapy helps to treat a variety of cancer types. Chemotherapy drugs can cause several side effects. Some side effects may occur during therapy and last long after it is over. Some side effects may occur long after treatment is over and linger.
Some symptoms may subside with time, and doctors can help a person manage these side effects. Other issues may be permanent. Doctors will discuss the risk of permanent complications with a person to help decide the best treatment options.