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Cancer treatment affects each child differently. Some side effects are temporary and manageable, while others may need closer monitoring or additional support. At OSF HealthCare Children’s Hospital of Illinois Cancer and Blood Disorders Institute, your child’s care team can help you understand what to expect, how side effects are treated and when to reach out for help so you feel prepared and supported throughout your child’s care.
Side effects occur when healthy cells are damaged. Different chemotherapy and radiation treatments cause different side effects. Side effects may happen right away, a week to ten days later, or even months to years later.
In general, the side effects from chemotherapy depend on the type and dosage. Side effects of radiation depend on which part of the body is treated.
Your health care provider will talk with you about the side effects that your child may experience.
Some children experience changes in appetite, such as not feeling hungry or eating less than usual during cancer treatment. Both cancer and its treatment can affect appetite, and feelings like fear, worry or stress can also reduce a child’s desire to eat. Some children may feel hungry but become full quickly, which can limit how much they eat. If appetite changes last over time, they may lead to poor weight gain or weight loss.
Constipation is a condition that happens when a child has hard stools (bowel movements) and is either unable to go to the bathroom regularly or has difficulty when trying. Some types of chemotherapy, such as vincristine and pain medications can cause constipation.
Fever, vomiting and diarrhea can cause dehydration, especially if your child cannot drink enough to replace lost fluids. Signs of dehydration in children may include fewer wet diapers or trips to the bathroom, dark-colored urine, dry mouth or lips, no tears when crying, unusual tiredness or dizziness.
If your child has diarrhea, bowel movements or stools that are loose and watery, tell your health care provider the color, amount and number of times in a day that it occurred. If your child has ongoing diarrhea, please call OSF Children’s Hospital Cancer and Blood Disorders Institute at (309) 624-4945 as soon as possible.
Many children with cancer experience fatigue during and following treatment. Children may describe fatigue as being tired and/or feeling weak. While fatigue is normal, if your child is not acting like themselves or seems “out of it”, call OSF Children’s Hospital Cancer and Blood Disorders Institute at (309) 624-4945 as soon as possible.
While a fever may be a sign of a serious infection in anyone, in a child with cancer, it can be quite serious. Left untreated, your child could become very ill. If your child has a fever of 100.4 F or higher, call your health care provider right away. Do not wait until your medical facility opens. Call OSF Children’s Hospital Cancer and Blood Disorders Institute at (309) 624-4945 as soon as possible.
Some kinds of chemotherapy and radiation therapy to the head may cause hair loss or thinning of the hair. Hair loss may start seven to ten days after the first treatment. In some cases, all of the hair falls out, including eye lashes, eye brows, underarm or leg hair.
Platelets stop bleeding in the body by forming clots. When the platelet count is low, also known as thrombocytopenia, your child may be at risk for too much bleeding. Signs of a low platelet count can include easy bruising, tiny red or purple spots on the skin, bleeding gums or prolonged bleeding.
Red blood cells carry oxygen from the lungs to the rest of the body through a protein called hemoglobin. When a child has a low red blood cell count, also called anemia, their body may not get the oxygen it needs to function normally. Children with anemia may appear more tired than usual, feel weak or dizzy, or become short of breath, especially during activity. Other signs can include pale skin or lips, headaches, rapid heartbeat, or feeling cold.
White blood cells help your child’s body fight infection. When the white blood cell count is low, called neutropenia, your child has a higher risk of getting sick. A child with neutropenia may not show typical signs of infection. Fever may be the only warning sign, even if your child otherwise seems okay. Other symptoms to watch for include chills, sore throat, cough, mouth sores, redness or swelling around a central line or port or unusual tiredness.
Cells in the mouth can be affected by chemotherapy and radiation therapy to the head and neck. As such, it’s important to keep the mouth and teeth as clean as possible by gently brushing with a soft bristle toothbrush and mild toothpaste. Your care team may recommend using an antiseptic mouthwash to reduce the risk of mouth sores. Your child will feel more comfortable, and you can help prevent mouth sores or other infections.
Chemotherapy and radiation therapy can cause nausea, vomiting and diarrhea. Any of these symptoms can place your child at risk for dehydration. If your child has ongoing vomiting, please call OSF Children’s Hospital Cancer and Blood Disorders Institute at (309) 624-4945 as soon as possible.
There are many causes of pain in children with cancer. Cancer cells in the blood or solid tumors in the body can cause bone or tissue pain. Some side effects of cancer treatment, such as mouth or skin sores, can be painful. Tests, like bone marrow aspirates and lumbar punctures, can be painful.
It is important to tell your health care team if your child has pain anywhere in the body, at the central line/port catheter site or pain while using the bathroom, so they can determine the cause and work with you to create a plan to decrease the pain as much as possible.
Skin changes while undergoing cancer treatment are very common. These coloration changes, also called radiation dermatitis, can appear after receiving radiation therapy. Treat the skin that is exposed to radiation with extra care. The skin in the area receiving treatment may become red and sensitive, similar to sunburn. Radiation can also cause hair loss in the area being treated.
Steroids, such as prednisone or dexamethasone, may cause your child to gain excess weight. Steroids can cause an increase in appetite and a build up of fluid.
Many children lose weight during chemotherapy or radiation treatments. Your health care team will closely watch your child’s weight and help plan a healthy diet.
Problems related to cancer treatment that occur or persist after treatment is completed are known as late effects. Unfortunately, about three out of five childhood cancer survivors develop some form of late effect.
Because early detection is key to effective treatment, ongoing follow-up care is essential for every survivor. Our team at OSF Children’s Hospital of Illinois Cancer and Blood Disorders Institute ensures your child receives the appropriate screenings and counseling to identify and manage any cancer-related late effects as early as possible.
Here are some of the more common late effects that can occur after treatment for childhood cancers. While this list covers several prominent issues, every child’s experience is unique, and other late effects may also occur. If you or your child have any concerns about long-term health, please speak with your child’s care team to better understand and address these impacts.
Avascular necrosis (AVN) is a disorder resulting from a temporary or permanent loss of blood supply to the bone. Blood carries essential nutrients and oxygen to the bones. When the blood supply is disrupted, the bone tissues begin to break down. This can weaken the bone and eventually result in its collapse. If this occurs near a joint, it can lead to the collapse of the joint surface, resulting in arthritis, which is pain and inflammation along the joints. AVN is also referred to as osteonecrosis, aseptic necrosis, or ischemic bone necrosis.
During childhood and into young adulthood, bone formation occurs faster than bone loss, causing bones to grow and become heavier and more dense. As a person ages, the process of bone removal gradually overtakes bone formation, and bones slowly lose strength as part of the normal aging process.
Osteoporosis is a disorder resulting from too little new bone formation or too much bone loss, causing bones to become weak. Most people do not have symptoms, especially in the early stages. As bones become weaker, fractures may occur after minimal trauma, such as a fall. Osteoporosis may occur in any bone, but most commonly affects the wrist, leg and hip bones.
Several studies have shown that women treated with radiation to the chest for cancer during childhood, adolescence, or young adulthood have an increased risk of developing breast cancer as they get older, compared to women their same age in the general population.
Hormones are chemical messengers whose job is carry information from the endocrine glands through the bloodstream to the body’s cells. Hormones are produced in the body’s endocrine system, which is a group of glands whose job is to regulate body functions that include puberty, growth, energy, and stress response. Glands of the endocrine system include the pituitary, hypothalamus, thyroid, adrenals, pancreas, ovaries and testes.
Peripheral neuropathy, damage to the nerves outside the brain or spinal cord, is a potential side effect of chemotherapy drugs and may cause the hands or feet to hurt, tingle, and feel numb or weak. Though the discomfort is felt in a muscle or joint, the real damage is to the nerves that control the muscles.
Cancer and its treatments can affect a child’s senses – seeing, hearing, tasting, smelling and touching – which may change how they experience everyday activities. Children may notice food tastes different, smells seem stronger or they feel more sensitive to touch, light or sound. Some treatments can also cause temporary changes in vision or hearing. These changes can impact eating, sleep, comfort and mood, so it’s important to share any sensory changes with your child’s care team so they can help manage symptoms and keep your child as comfortable as possible.
Raynaud’s phenomenon is a condition that can cause fingers, toes, ears, or the nose to feel cold, numb, or tingly in response to cold temperatures or stress. During an episode, blood vessels temporarily narrow, which can limit blood flow and cause the skin to turn white, blue, or pale, and then red or flushed as circulation returns. These color changes and sensations usually last a short time but can be uncomfortable, especially during cancer treatment. Let your child’s care team know if you notice frequent or severe symptoms.
Learning about the risk of developing secondary cancer can be frustrating and anxiety provoking. After facing cancer as a child, the last thing someone wants to think about is the risk of developing a second cancer during adulthood. If you are concerned, talk to your care team about the risks of secondary cancers and recommended screenings.
Some treatments for children’s cancer may affect the thyroid gland, which helps control growth, energy and metabolism. Thyroid problems are usually easy to treat, especially when found early. Signs may include unusual tiredness, weight gain or weight loss, feeling cold or warm more often than usual, changes in mood or concentration, dry skin or slowed growth. Regular check-ups and blood tests can help identify thyroid problems early so the right treatment can begin promptly.