Cancer treatment in children may cause several different side effects. These can vary depending on the type of cancer, its stage and the kind of treatment that is being given. It is important to understand these effects and their short and long-term impacts.

At Icon we are here to help you manage these side effects, both during your time with us and beyond. Please do not hesitate to discuss all the side effects with your care team at any time. For more information on managing side effects during or after treatment, click here.

Short-term side effects that may be experienced during cancer treatment include:

• Appetite and taste changes – a change in taste and smell is a common side effect during or following cancer treatment. Normal taste and smell usually returns two to three months after your treatment finishes.
• Nausea or vomiting – feeling sick or queasy (nausea) and vomiting (throwing up) is a common problem for people being treated for cancer, however there are many things that can help nausea and vomiting become well managed and controlled.
• Diarrhoea – refers to increased frequency and decreased consistency of bowel motions. Symptoms can range from mild to severe and generally last for several days after treatment.
• Constipation – this may include passing bowel motions less frequently than usual; passing dry, hard stools or having to strain to open the bowels. This can lead to abdominal pain, nausea and/or vomiting, abdominal distention and loss of appetite.
• Weight changes, including weight gain and weight loss – may be caused by chemotherapy and associated side effects.
• Mouth sores – occur when the lining of the mouth is damaged following chemotherapy or localised radiation therapy. All chemotherapy drugs have the potential to cause mouth sores.
• Fatigue – a feeling of exhaustion and lack of energy. As you reach the end of your treatment your fatigue may worsen, however this usually resolves a few weeks after treatment ends.
• Infections – often caused by neutropenia. Neutropenia is when neutrophils, a type of white blood cell that helps fight infection, are low. The lower your neutrophil count drops the greater the risk of developing an infection and the harder it is for the body to deal with the infection on its own.
• Bleeding and low platelets – also known as thrombocytopenia, a reduction in the normal levels of functional platelets. This can increase your risk of bruising and bleeding.
• Hair loss – most children will experience hair loss during their cancer treatment. Hair loss will usually occur a few weeks into your treatment. Chemotherapy will cause hair loss all over the body, whereas radiation therapy only affects hair in the treatment area.

While not everyone will experience long-term or late side effects, in some instances these can include:

• Learning difficulties, seizures or frequent headaches – most common in very young children who receive chemotherapy and radiation therapy for brain tumours.
• Pituitary problems – caused by radiation therapy treatment which is targeted near the pituitary gland in the brain.
• Vision issues, including poor vision, eye irritation or light sensitivity – often associated with retinoblastomas and radiation therapy or surgery near the eye or optic nerves.
• Hearing loss and issues such as ringing in the ear or dizziness – most common in children who receive radiation therapy or surgery to the brain or ear.
• Thyroid issues, such as low thyroid function or an overactive thyroid – caused by radiation therapy or surgery in the head and neck area.
• Stunted bone growth and bone and muscle problems, including unequal limb growth, pain, stiffness and weak bones – radiation therapy treatment can have a significant impact on the growth of bone and muscle in children and young adults.
• Increased risk of cancerous tumours – these tend to develop in the area that received radiation therapy treatment.
• Heart issues – may be caused by certain chemotherapy drugs or radiation therapy to the chest or spine.
• Lung problems, such as decreased lung volume, shortness of breath, pulmonary fibrosis and increased risk of lung infections – can occur in children and young adults who receive radiation therapy to the chest or certain chemotherapy drugs.
• Teeth and mouth issues, such as changes to normal tooth development or enamel, increased risk of cavities, intense sensitivity, gum disease, short roots and decreased saliva/dry mouth – typically associated with radiation or chemotherapy in an area that involves the teeth and jaw.
• Slowed growth – can be caused by certain chemotherapy drugs and radiation therapy.
• Infertility and issues with sexual development – often associated with chemotherapy or radiation therapy that is targeted at the testicles, uterus, ovaries or pituitary gland.

Although long-term side effects can be concerning, it is important to remember that they are the result of lifesaving treatment. Your Paediatric Haematologist-Oncologist will discuss all the possible side effects associated with recommended treatments to ensure that you can make an informed decision together.