Fatigue is the most common complaint of cancer survivors. Cancer-related fatigue results from the cancer, its treatment, and treatment side effects. Survivors often complain that they can't get over feeling tired, regardless of how much sleep they get. If you are experiencing fatigue, talk to your physician about coping strategies such as exercise, relaxation skills and energy conservation.
Steroid drugs used to treat certain cancers may increase blood glucose levels (hyperglycemia) in some patients who do not have diabetes. Although it's unclear if these patients will develop diabetes, they are at higher risk because their glucose levels may remain elevated after treatment stops.
Men and women whose cancer treatments are designed to eliminate the sex hormones that many cancers need to grow may experience the following side effects:
- Decreased sex drive
- Memory loss
- Decreased muscle mass
- Weight gain
- Loss of body hair
Survivors of Hodgkin's disease who were treated with radiation therapy often suffer from hypothyroidism, a condition in which there is too little thyroid hormone. Symptoms include weight gain, constipation, dry skin and sensitivity to cold. Hypothyroidism can be treated with medication.
Removal of the prostate or bladder increases the possibility of incontinence or urine leakage while coughing, sneezing or straining. Survivors with rebuilt can gain an element of bladder control through special exercises, but incontinence while sleeping is inevitable.
Either chemotherapy or radiation may cause infertility in both sexes. In women, chemotherapies with alkylating agents such as cyclophosphamide can damage the ovaries, resulting in irregular or absent menstrual periods.
Men with colorectal or genitourinary cancers who have had chemotherapy and radiation therapy are at increased risk of infertility. Chemotherapies that affect male fertility include alkylating and methylating agents, vinca alkaloid, antimetabolite, and platinum.
Learning & Memory Problems
Many cancer patients have problems with learning and memory during and immediately after treatment. Researchers have also discovered that the cancer itself may affect verbal learning and memory functions. The good news is that memory loss is one side effect that improves in long-term survivors. Cognitive problems resulting from chemotherapyis called "chemobrain."
Lymphedema occurs when lymph nodes under the arm are damaged by radiation or surgically removed as part of breast cancer treatment. Lymphatic fluid accumulates in the tissue, causing painful inflammation and limited arm function. It's estimated that 12-25% of breast cancer patients develop lymphedema, mostly in the first year after treatment. However, lymphedema can occur many years later.
One of the most difficult treatment side effects is neuropathy, a tingling or burning sensation in the hands and feet due to nerve damage. Neuropathy can be caused by radiation, surgery and chemotherapies such as taxanes, platinum, vincristine, and thalidomide. Neuropathy is generally thought to be irreversible and can progress.
Bone loss is a common side effect for survivors of lymphoma, leukemia, breast and prostate cancers. Osteoporosiscan be caused by the cancer itself, cortisone-type drugs, treatment-induced menopause, cancer cells in the bone marrow and treatments that affect testosterone, which is crucial to bone health.
Pain can be a side effect of treatment or from the cancer itself. While pain management in patients undergoing active cancer treatment has improved significantly in recent years, little is known about long-term pain among disease-free survivors, which can be severe and affect quality of life.
Erectile dysfunction is a common side effect of prostate cancer treatment. A significant number of men report dissatisfaction with their sexual function following cancer treatment.
Early menopause in female cancer survivors can affect sexual function. Symptoms such as hot flashes, joint pain, headaches, mood swings and vaginal dryness can impact sexual desire. Because women with estrogen-receptive cancers may be discouraged from using hormone replacement therapy, their options for addressing menopausal symptoms are limited.
Xerostomia (dry mouth) is common in head and neck cancer survivors because salivary glands are susceptible to radiation damage. Xerostomia makes it harder to swallow, sleep, and speak, and is associated with loss of appetite due to altered taste.
Long-Term Side Effects
Many cancer survivors face some of the following late or long-term physical side effects.
Cancer Recurrence or Secondary Cancers
All cancer patients live with the possibility that their cancer will recur or spread (metastasize). Some patients also may develop secondary cancers, some of which may be a result of treatments used for their original cancer.
Cancer patients treated with certain chemotherapies and radiation may experience health conditions normally seen in older people. One of the most common long-term side effects for women is early menopause, which also increases the risk for osteoporosis. The effects of cancer treatment on men include osteoporosis, incontinence, infertility, and erectile dysfunction or impotence.
Certain types of cancer treatments can age or damage vital organs, causing long-term health problems. These may become apparent only as the survivor ages or develops other medical conditions years after therapy. Some chemotherapy drugs are known to be toxic to the heart, including Herceptin and doxorubicins.