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Survivorship Callenges

Survivorship issues address the physical, emotional and practical aspects of coping with cancer after treatment is over. Anyone affected by cancer is a survivor––the person diagnosed, his or her family, friends and caregivers. While some survivorship issues begin at the moment of diagnosis, others, such as “late effects,” may occur months after treatment has ended.

What are late effects?

Late effects are health problems that result from cancer treatments such as chemotherapy, radiation therapy, bone marrow transplants and stem cell transplants. The health problems can be subtle or severe, and they can occur during treatment or not until months or years after treatment is over.

Late effects in childhood cancer survivors can surface in:

  • Organs, bones or body tissues 
  • Mood, feelings and actions
  • Thinking, learning and memory

They can include:

Physical Issues

  • Lack of concentration
  • Fatigue
  • Chronic pain
  • Second cancers
  • Fertility problems
  • Neuropathy

Emotional Issues

  • Body image
  • Fear of recurrence
  • Grief and loss
  • Sadness and depression
  • Reentry into school
  • Reestablishing friendships

Practical Issues

  • Finding specialized follow-up care
  • Communicating with your health care team
  • Life expectancy
  • Health insurance
  • Quality of life and palliative care

Who experiences late effects?

According to the National Cancer Institute, the risk that a cancer treatment will cause late effects depends on a number of things, including:

  • The type of cancer and where it is in the body
  • The child’s age (when treated)
  • The type and amount of treatment
  • The area treated
  • Genetic factors or health problems the child had before the cancer

Why is follow-up care important?

To manage late effects, it’s very important that pediatric cancer survivors have regular follow-up visits with health professionals who are trained to recognize late effect symptoms. During follow up exams doctors can also identify recurrences, signs of spreading, or development of a second cancer. In addition to follow-up care, patients should keep track of changes in their health and alert their doctor to any symptoms that arise.

Get helpful information and resources for survivors »

Sources »



Pre-teen Jen, in glasses, being held by her dad, they both have broad smiles - "I feel stronger. I feel that I can do more. I'm on the swim team and we made it to the championships and that's on Tuesday and it starts at like 5:30 in the morning. Yeah!" --Jen Moore, cancer survivor