Facing Fears of Long Term and Late Effects From Your Cancer Treatment

It used to be that the fear of recurrence was the only big fear we had to face after treatment for cancer, but things have changed in the past decade with the discovery and validation that there are a number of long term and late effects that need attention after treatment. Of course, they all depend on the location of the cancer, the kind of treatment received, and the individual’s physical health and genetics, which makes it even more complicated.

I can remember having a heart scan when I started treatment to be sure my heart was healthy enough to proceed with the drugs that had shown possible cardiac problems after treatment. All was well back then, but not so since then.

Because I have been so immersed in survivorship issues, I had my first heart test some 15 years after treatment ended. There were little things that could be better but nothing to say my heart wasn’t doing well enough to keep going for quite a while. I did have to convince the receptionist that seeing a cardiologist after cancer treatment was legitimate and I wasn’t a hypochondriac.

In fact, heart problems were beginning to show up in the survivorship community, and doctors began to connect them to cancer treatment. Cardiac issues have become so prevalent that there is now a cardiac specialty called cardio-oncology, which focuses on the patient’s heart after their cancer treatment.

Other late-term issues include hypertension, soft tissue problems, learning and memory problems and peripheral neuropathy in hands and feet which can be very painful and lead to other challenges such as a condition called Charcot foot, where the bones in the feet become weakened due to neuropathy and eventually fracture.

Doctors have been reluctant to connect many of these issues to cancer treatment because of the lack of research, but they do reinforce the use of survivorship care plans where late effects can be noted and watched for. Knowing which conditions are connected to which treatments can give you a head start on what method might be needed to stave off conditions that could be lingering in the shadows.

My early cardiology tests didn’t prepare me for the day in 2017 when shortness of breath made it almost impossible to walk from my bedroom to the kitchen. The diagnosis: congestive heart failure whose symptoms showed up when my heart went into what is called A-fib, an irregular heartbeat that many people live with for years. In my case the A-fib was fast, and I couldn’t tolerate the shortness of breath, so I was shocked back into normal rhythm and the symptoms went away.

I suggested to a number of friends that they have heart follow up and two of them were unknowingly living with the early stages of heart failure. This condition is manageable, and my cardiologist has assured me that with the correct medicine, I have years to live.