Cancer treatments such as chemotherapy can come with the risk of side effects. Doctors may prepare a person for short-term side effects, such as hair loss and fatigue, but there may also be long-term effects of chemotherapy.

These 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 the treatment.

There is no exact timeline for when long-term side effects will appear or go away, and if they do arise, they may not always be treatable. A person can work with a doctor to 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.

A person experiencing side effects of chemotherapy, including fatigue and hair loss.Share on Pinterest
Miquel Llonch/Stocksy

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.

In addition to targeting cancerous cells, chemotherapy affects healthy cells such as those in the bones and marrow. This may speed up bone loss, leading to broken bones. Chemotherapy can also cause dietary problems and may make it possible for a person to have bone issues resulting from vitamin D deficiency.

Other therapies, such as hormone therapies, may also affect the bones and bone density. A person who undergoes hormone therapy as part of their cancer treatment may experience bone density changes.

Doctors may recommend taking a baseline bone density measurement before starting treatment. 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

In some people, chemotherapy may cause late side effects in the heart, such as:

Research from 2017 notes that some side effects, such as cardiovascular (heart and blood vessel) complications, may not occur until 20 years after cancer treatment.

Heart-related side effects may be more pronounced if a person undergoes other therapies in the same area of the body, such as chest radiation therapy for lung cancer.

Lung conditions

Chemotherapy may cause lung conditions such as:

Lung problems may be more likely with specific drugs or with treatments that target 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, and focus. For example, a person may lose track of their keys and have difficulty doing daily activities that require multitasking 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 address these problems. 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 body image difficulties are common in cancer survivors. Research from 2018 notes that up to 20% of people with cancer experience depression — this is four times the rate of depression in the general population.

Long-term mental health conditions can be a challenge. However, a mental health professional may be able to 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 65% of people undergoing chemotherapy experience hair loss. This percentage may increase depending on the drug.

A person may lose some or all of their hair during treatment. Hair typically starts to grow back once a person completes treatment. However, in some people, the hair that regrows may have a different texture, grow differently, or have a different color than it did before.

Hair loss generally improves with time. In rare cases, such as when a person undergoes intense chemotherapy for long periods, hair loss may be permanent.

Fatigue

Fatigue occurs with chemotherapy treatment but may also linger after treatment. If fatigue is a long-term issue after chemotherapy, a person should talk with a doctor to explore possible reasons and options for managing these effects.

Endocrine symptoms

Cancer treatments that affect the endocrine system may cause a person to have symptoms of menopause, such as:

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 as a result of cancer treatments for the prostate or testicles or 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 undergoing chemotherapy treatment. A person should discuss infertility risks with a doctor before starting chemotherapy.

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 experience infertility after treatment.

Nerve damage

Nerve damage, or peripheral neuropathy, is a potential side effect of chemotherapy with various cancer types and treatments.

Other conditions, including chronic conditions that affect the nerves, may make peripheral neuropathy more likely.

A person should speak with a doctor about their risk of nerve damage. Other risk factors for nerve damage may include diet, other health conditions, and the type of chemotherapy drug a person receives.

Nerve damage may improve with time. However, for some people, it may be permanent.

Dental issues

Chemotherapy may affect the enamel of the teeth and 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 decrease saliva production.

Dental problems could be more likely in people who receive treatment for cancer of the head and neck.

Regular checkups with a dentist may help identify and treat problem areas. Some topical creams and toothpastes may help with tooth sensitivity.

There is no set timeline for 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.

Below are some commonly asked questions about long-term side effects of chemotherapy:

Can chemo have side effects years later?

Side effects of chemotherapy can last long after treatment is over. In some cases, side effects may not occur until months or years after chemotherapy.

Does your body ever fully recover from chemotherapy?

Chemotherapy can cause long-term changes in the body, months or years after treatment. In some cases, the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs.

Chemotherapy helps treat a variety of cancer types. Chemotherapy drugs can cause several side effects, some of which may occur during therapy and last long after it is over. Some side effects may begin long after treatment is over and linger.

Some symptoms may subside with time, and doctors can help a person manage them. Other effects may be permanent. Doctors will discuss the risk of permanent effects with a person to help them choose the best treatment options.