The effects of chemotherapy can continue after treatment or even develop years later. These include effects on the brain, heart, bones, nervous system, lungs, and other systems.
Chemotherapy is the most common form of treatment for cancer. It uses aggressive drugs to slow the growth of cancer cells.
You might already be aware of the short-term side effects of chemotherapy, like hair loss and nausea.
The long-term side effects are less well known. These include side effects that start during chemo or shortly after and persist for a long time. They also include “late effects,” which may not start until months or years after you complete treatment.
This article reviews the potential long-term effects of chemotherapy. However, long-term effects vary according to the individual, type of cancer, and type of chemotherapy drug used.
One of the short- and long-term side effects of chemotherapy is mental fogginess, often referred to as “chemo brain.” It includes problems with memory, concentration, and multi-tasking. In some cases, these cognitive challenges persist for several years after treatment is complete.
Chemotherapy can contribute to oxidative stress and inflammation that affects your cognition. However, other factors can contribute to this symptom, such as the cancer itself or stress from a recent diagnosis.
You may be able to prevent or alleviate cognitive difficulties by:
- eating a balanced diet
- getting enough sleep
- doing brain exercises
Certain chemotherapy drugs can lead to long-term hearing loss. These include carboplatin and cisplatin.
Research suggests that cisplatin may remain in the inner ear after treatment, contributing to hearing problems such as tinnitus. Higher doses and increased treatment frequency may be associated with more severe hearing-related effects.
If you’re receiving carboplatin or cisplatin chemotherapy, talk with your doctor about the risks to your hearing.
Chemotherapy can lead to high blood pressure and heart diseases, including:
The risk of developing a heart problem after chemotherapy is greater for those who are over 65 and those who received higher doses of certain drugs.
Chemotherapy drugs that damage the heart and circulatory system issues include:
| Drug class | Examples |
|---|---|
| anthracyclines | doxorubicin, daunorubicin, epirubicin |
| antimetabolites | 5‐fluorouracil, capecitabine |
| alkylating agents | cyclophosphamide, cisplatin |
| taxanes | paclitaxel, docetaxel |
Other targeted cancer drugs may also increase your risk of heart problems.
If you’re prescribed one of these drugs, your healthcare team will carefully monitor your heart and circulatory system function before, during, and after treatment. If a problem occurs, your doctor might change your dose, prescribe protective medication, or stop the treatment altogether.
You can also
Research links chemotherapy to a slight increase in the risk of blood cancers.
A 2018 study of 165,820 older adults who underwent chemotherapy for any type of solid cancer found an increased risk of developing acute myeloid leukemia or myelodysplasia within 5 years.
More research is needed to understand why these cancers develop and whether they can be prevented. Your doctor will help you weigh the risks and benefits of your treatment.
Chemotherapy can cause inflammation and scarring in your lung tissue. This can lead to lung problems that may develop years after treatment. Chemo may increase your risk of:
- pulmonary fibrosis
- infections, like bronchitis or pneumonia
- pneumonitis
- acute respiratory disease syndrome
These conditions may cause symptoms such as chest tightness and difficulty breathing.
Chemotherapy drugs linked to lung conditions include:
- bleomycin
- carmustine
- mitomycin
- methotrexate
Although it may not be possible to prevent lung damage caused by chemotherapy, you can take care of your lungs by exercising regularly, avoiding lung irritants, and quitting smoking if you smoke. Tell your doctor if you’re experiencing lung symptoms such as shortness of breath.
Some chemotherapy drugs can damage the nervous system, causing symptoms that can
- neuropathic pain, which causes burning or tingling in your limbs
- reduced reflexes
- weakness
- muscle cramps
These symptoms are most commonly reported in people who take platinum compounds (like oxaliplatin) and taxanes (like docetaxel).
Neuropathic pain is
While there’s no known way to prevent it altogether, you may be able to ease the pain by adopting a healthy lifestyle, taking your medications as prescribed, and wearing loose-fitting hand and footwear.
Chemotherapy drugs can thin and weaken the bones. This condition is called osteoporosis. It’s more likely to occur in women experiencing menopause, as menopause is also associated with a loss of bone density.
Having osteoporosis puts you at an increased risk of breaking a bone. To mitigate the risk, your doctor might suggest increasing your dietary calcium intake, taking a calcium supplement, or taking medication to improve bone strength.
Chemotherapy drugs can affect your hormones, your sex life, and your reproductive system. In females, it can increase your susceptibility to infections or trigger early menopause. Males may experience erectile dysfunction.
Several chemotherapy drugs, such as alkylating agents, can cause infertility. Infertility may disappear following treatment, but in some cases, it may be permanent. Whether or not you experience this side effect depends on your overall health, your age, and the type and dose of chemotherapy drug you receive.
Your doctor will make sure you’re aware of the risks associated with treatment. If having children is a concern, they might suggest freezing your eggs or sperm banking before treatment begins. A fertility specialist can help you explore your options.
The side effects of chemotherapy can linger for months and sometimes years. It depends on your overall health and the type of chemotherapy you receive as treatment.
Some complications of chemotherapy are permanent. These can include damage to your respiratory, circulatory, sensory, excretory, and reproductive systems.
Before receiving chemotherapy, ask your doctor or oncologist about the likelihood of long-term or permanent side effects.
Chemotherapy can cause several late-term side effects. These may start during treatment and continue after it’s done. In other cases, they appear for the first time after chemotherapy is finished.
Side effects can vary according to your health, the type of cancer you have, and other treatments you receive.
If you’re receiving chemotherapy, speak with your healthcare team about potential side effects.