All medical treatments have both benefits and potential harms. This is no less true for cancer treatments than for other medical therapies. Some cancer treatments have side effects even after they have led to a cure. This is especially true for childhood brain cancer and leukemia. Now that childhood cancer survivors are living longer, researchers are beginning to learn more about the possible late side effects of childhood cancer treatments.

Your child’s doctor will make every effort to select treatments that will minimize future risks, as well as discuss what you and your child can expect. This article will acquaint you with some topics that might come up in such a discussion. It is important to keep the possible long-term side effects of cancer treatment in perspective.

Many cancers are treated with radiation (high-energy rays that kill or shrink cancer cells) or with chemotherapy, which are drugs designed to kill cancer cells while causing the least harm possible to normal tissues. Two side effects of radiation and chemotherapy that often raise concern are the risk of a second cancer developing at some later time, and the potential risk to a child’s future fertility.

Children who have been successfully treated for childhood cancer face a small but increased risk of developing a second cancer—of an entirely different kind—during their lifetime. Scientists still don’t completely understand second cancers and they currently have no way of predicting which children are susceptible and which children are not. This risk will likely diminish in the future as doctors use new cancer treatments specifically designed to minimize the development of second cancers.

While most childhood cancer survivors are able to have children, fertility problems can still occur due to cancer treatment. Radiation and chemotherapy affect pregnancy rates more than other treatments, and boys’ fertility tends to be a greater issue than girls’. Treatment may lower sperm count in boys, while ovaries may be affected in girls.

Your child's doctor can advise you whether your child’s treatment has a significant chance of affecting fertility. The health of children born to survivors of childhood cancer is not affected by their parent’s history of cancer.

In today’s cancer centers for children, doctors and nurses make efforts to reduce the pain and fear associated with cancer. Despite these efforts, cancer is a frightening disease, and its treatment is rarely without some discomfort. Despite the best medical and nursing care, some survivors of childhood cancer find that memories and anxiety associated with cancer keep sprouting back into their lives, even years after treatment is finished. When fears and memories return frequently and intensely, psychologists may make a diagnosis of post-traumatic stress disorder (PTSD). PTSD does occur in some children who are cured of cancer.

In an effort to help your child from falling victim to PTSD, the oncology staff will likely want to talk with your child about her feelings. Many centers use play therapy so that younger children can express feelings of fear or anxiety. If you find your child continues to worry about cancer or to have disturbing memories or dreams about the treatment process, talk with your doctor about getting psychological help, which may prevent the long-term development of PTSD.