Long-Term Side Effects of Cancer Treatment

Approved by the Cancer.Net Editorial Board, 07/2023

Long-term side effects of cancer treatment are side effects that last months or years after cancer treatment ends. Sometimes, these side effects may not start until after treatment ends. They are sometimes called late effects. Many people who have had cancer treatment have a risk of developing long-term and late side effects.

Evaluating and treating long-term and late effects is an important part of cancer survivorship care. This article is about the different types of long-term side effects of cancer treatment. You can find more information about these side effects by clicking the links throughout this article or by viewing Cancer.Net's database of specific types of side effects you can experience during and after cancer treatment.

What are the causes of long-term side effects of cancer?

Any cancer treatment can cause long-term effects. Your risk of developing long-term and late effects depends on many factors, including:

  • The type of cancer and its location in the body

  • The part of the body that was treated

  • The type and dose of treatment

  • Age when treated for cancer

  • Genetics and family history

  • General health

  • Any other health problems that existed before the cancer diagnosis

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team, including your primary care doctor, will continue to check that cancer has not come back and manage any late or long-term side effects of your treatment. This is called follow-up care.

What are common types of long-term effects of cancer treatment?

Some possible long-term effects of cancer and cancer treatment include the following. Click each link to navigate to the part of the page that discusses that side effect and possible treatment options.

Bone, joint, and soft tissue problems after cancer treatment

Chemotherapy, steroid medications, and 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. Learn more about osteoporosis and joint pain caused by cancer treatment.

It is important to tell your primary care doctor and other members of your health care team about the treatments you have had. For example, some medications may cause damage to the jaw bone. It is important for your dentist to know that you have had cancer and the types of treatments you have had. See more below about dental care.

Return to top

Brain, spinal cord, and nerve problems after cancer treatment

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 platinum-based chemotherapy

  • 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 neuropathy

Return to top

Dental problems after cancer treatment

Cancer survivors may have dental and oral health problems, depending on the treatments they received. Chemotherapy can 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 dry mouth. Regular appointments with a dentist should be a part of your follow-up care after cancer treatment.

Return to top

Digestion problems after cancer treatment

Chemotherapy, radiation therapy, and surgery may affect how you digest 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 nutritionist (RDN) can help people with digestion problems get enough nutrients. It may also be helpful to see gastroenterologist. A gastroenterologist is a doctor who specializes in the digestive tract.

Return to top

Emotional effects after cancer treatment

Cancer survivors experience many emotions after cancer treatment. Some of these can be positive, including relief and a sense of gratitude. However, long-term emotional effects such as anxiety, depression, and a fear of cancer coming back are also common. Cancer survivors, caregivers, family, and friends may also experience post-traumatic stress disorder. This is an anxiety disorder. It may develop after living through a very frightening or life-threatening event, such as a cancer diagnosis and treatment.

Sadness, fear, and worry are normal emotions, especially after an experience with cancer. But if those feelings are long-lasting and impact your day-to-day life, it is important to seek help. For example, some survivors may avoid getting health care because of difficult memories and emotions. Working with a licensed therapist or psychiatrist or joining a support group can help. Sometimes, treatment with medication is helpful for depression and/or anxiety.

Each person's post-treatment experience is different. Learn more about coping with the different emotions that cancer can bring.

Return to top

Eye and vision problems after cancer treatment

Cancer survivors may have eye problems after taking certain medications used to treat cancer. Steroids, and some types of chemotherapy, immunotherapy, and targeted therapy can all affect vision. Eye problems caused by cancer treatment can include vision changes, watery eyes, dry eyes, eyelash changes, cataracts, and glaucoma. Schedule annual vision screenings or an appointment an ophthalmologist to discuss any vision changes. An ophthalmologist is a doctor who specializes in treating eye conditions.

Return to top

Fatigue after cancer treatment

Fatigue is the most common side effect of cancer treatment. It is a feeling of physical, emotional, and mental exhaustion even after getting enough rest and sleep. Some cancer survivors have fatigue for months or even years after finishing treatment. Learn more about cancer-related fatigue, including ways to cope.

Return to top

Heart problems after cancer treatment

Heart problems are an uncommon but serious side effect of some cancer treatments. This type of long-term side effect is called "cardiac toxicity." Examples of heart problems include congestive heart failure (CHF), coronary heart disease, an irregular heartbeat (arrhythmia).

A specific type of chemotherapy called anthracycline chemotherapy is known to cause heart problems. Other chemotherapy drugs, radiation therapy to the chest, and some types of targeted therapy can also cause heart problems. It is important to know if the treatment you have received can cause heart problems, especially if you have had heart problems in the past.

Some survivors are at a higher risk of heart problems after cancer treatment. This includes those who:

  • Received treatment for Hodgkin lymphoma as a child

  • Are age 65 and older

  • Received higher doses of chemotherapy

  • Received a combination of medications or treatments known to cause heart problems

Ask your doctor if the treatments you are receiving can affect your heart. They 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 (MUGA) scan.

Learn more about heart problems caused by cancer treatment.

Return to top

High blood pressure after cancer treatment

Your blood pressure shows how hard your heart is working to move blood through the circulatory system. You can have a blood pressure that is too low, normal, or too high. High blood pressure, which can lead to problems like heart disease, is called hypertension.

High blood pressure can happen along with other heart problems, such as congestive heart failure (see above). Or, it may be a separate symptom. Accelerated hypertension is when blood pressure suddenly and rapidly rises. It often causes organ damage. So it is important to get medical help right away.

High blood pressure that happens during cancer treatment may often go away when treatment ends. But sometimes it continues. Even if it goes away, the long-term effects of temporary high blood pressure are not known. Survivors with an increased risk for high blood pressure should work with their health care team to lower this risk. This may include regular testing of blood pressure, maintaining a healthy weight, eating less salt, taking medication, and being active.

Learn more about managing high blood pressure when you have cancer.

Return to top

Hormone problems after cancer treatment

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

Hormone problems can cause:

Return to top

Learning, memory, and attention problems after cancer treatment

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 health care team if you experience any of these issues.

Return to top

Long-term problems after cancer surgery

Many people have side effects after cancer surgery. Many side effects after surgery go away after you heal, but sometimes effects can last a long time. Long-term side effects from surgery depend on the type of cancer and where in the body you had surgery. Some examples of long-term side effects after surgery include:

  • Sometimes, part of your body is removed during surgery. For example, a splenectomy is the removal of the spleen. Survivors of Hodgkin lymphoma, rectal cancer, and other types of cancer may have had their spleen removed. The spleen is a vital organ for the body's immune system. Removing it is linked with a higher risk of infections for the rest of a person's life.

  • 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. Talk with your health care team about ways to cope with your emotions and changes to your self-image.

  • People who had 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.

Return to top

Lung problems after cancer treatment

Chemotherapy and radiation therapy to the chest may hurt the lungs. Cancer survivors who received both chemotherapy and radiation my have a higher risk of lung damage. People who have had lung disease and adults age 65 and older may have more lung problems. Always let your health care team know about problems or changes related to your breathing.

Drugs that may cause lung damage include bleomycin (Blexane), carmustine (Becenum, BiCNU, Carmubris), and methotrexate (multiple brand names.)

Lung problems caused by cancer treatment can include:

  • Changes in how well the lungs work

  • Thickening of the lining of the lungs

  • Inflammation of the lungs

  • Difficulty breathing

Return to top

Second cancers

When a person who has already had cancer develops a new cancer, it is called a second cancer, secondary cancer, or second primary cancer. It is a completely new and different type of cancer than the first one. It is not the same as a cancer recurrence. A recurrence means that the first cancer has come back, in the same part of the body or in a different area.

A second cancer may be a late effect of your first cancer or its treatment. Or, it can be unrelated to your first cancer. Second cancers are becoming more common since more people live longer after their first cancer diagnosis than ever before. Learn more about second cancers.

Return to top

Questions to ask the health care team

Learn as much as you can about the potential long-term effects of your cancer treatment from your health care team. This can help you feel more prepared if these problems do begin and next steps to take. Consider scheduling a special appointment with your doctor to review your treatment summary and your cancer survivorship care plan. This document should include information about your cancer, treatment, and planned follow-up care to watch for recurrence and long-term side effects. The American Society of Clinical Oncology offers forms to store this information.

Consider asking your health care team these questions about your cancer survivorship care and long-term and late effects:

  • Am I at risk for specific late effects from my cancer or its treatment?

  • What signs or symptoms of long-term effects should I watch for?

  • Are there any signs or symptoms I should tell you or another member of the health care team about right away?

  • Could cancer rehabilitative services help me with preventing or relieving late side effects?

  • Should I see other specialists to watch for or address long-term side effects?

  • How can I get a survivorship care plan? Who can

  • What can I do at home to support my health and well being?

Related Resources


What Survivors Should Know When Transitioning From Cancer Care to Primary Care After Treatment: An Expert Q&A

Fear of Treatment-Related Side Effects

3 Tips for Transitioning Out of Cancer Treatment

Why I Won't "Get Over" Cancer's Long-Term Effects

Late Effects of Childhood Cancer

More Information

LIVESTRONG: Late Effects of Cancer Treatment