Late Effects of Childhood Cancers

Today, most childhood cancer patients survive into adulthood. This is a great achievement of medical science. As more and more patients survive, however, it has become clear that many will experience “late effects” – side effects from their cancer treatments that did not develop for months, and sometimes years, after the treatment concluded. It is estimated that two-thirds or more of childhood cancer survivors will eventually experience at least one late effect.

Siteman Kids at St. Louis Children’s Hospital offers a number of options for patients to help prepare for and even prevent the difficulties caused by late effects.

There are three different types of late effects: physical, emotional, and cognitive. Childhood cancer patients should have a physical exam at least once a year to check for late effects. Developing good healthy living habits, such as eating well and exercising, can sometimes help limit late effects and ensure general well-being.

Physical late effects

Physical late effects impact the child’s body. They can include difficulties with growth, issues with the heart or lungs, or trouble conceiving or carrying children in adulthood.

Emotional late effects

Emotional late effects can involve depression or PTSD. You may notice that your child experiences insomnia, anxiety, flashbacks, or a reduced attention span. He or she may also cease to take interest in favorite activities and struggle with his or her social life.

Cognitive late effects

Cognitive late effects are more likely when children have received treatments to the head and brain, or were treated at a very young age. The child will begin to have difficulty with learning, clear thinking, and memory.

How Siteman Kids can help

There are several lines of support available for patients at Siteman Kids, or for former pediatric cancer patients in the St. Louis area.

First, you should feel free to discuss late effects with your child’s care team. They will know which effects are most likely to arise from your child’s specific treatments and can help you prepare. Some options we might suggest include:

• Counseling: Speaking with a therapist can help children process what they have experienced and develop healthy coping methods for anxiety, depression, and PTSD.
• Fertility preservation: We offer all pediatric cancer patients a consultation with a fertility specialist to discuss ways to help them have children as adults. Learn more about our fertility preservation program here.
• School support: We will develop a plan to help our patients transition back into the classroom and keep up with their peers.

The Siteman Lifelong Outcomes Clinic, which opened in 2017, sees patients over 18 who were treated for pediatric cancer more than two years ago. Medical staff at the clinic will meet with patients and refer them to physicians who are best able to manage their long-term care. Every patient will receive a plan for follow-ups. This clinic helps Siteman Kids patients transition to adult care at the Siteman Cancer Center.

St. Louis Children’s Hospital also sponsors a Late Effects Clinic. This clinic, available to former Siteman Kids patients as well as other former pediatric cancer patients in St. Louis, provides health screenings, education about how to cope with late effects, and referrals to physicians and other sources of community support.