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Side Effects of Treatment


Cancer survivors often deal with side effects from their treatments. Many of these effects are temporary, others intermittent, and some longer lasting.

Not everyone has these effects from their treatments. We invite you to read what is relevant to your journey and at your own pace. We hope to empower you with this information as well as the resources provided under each topic.

We hope that by providing details about potential side effects, you will add this information into your treatment decision-making process.

Remember that this involves weighing the risks and benefits of each treatment option separately and arriving at a decision that provides you with a balance that you are comfortable with.

We have several worksheet templates in development to help you do this. To access information about those templates visit our Tools section, or after finishing this section, read the section on Decision Aids.

This section discusses the following topics

  • Early onset side effects (researchers call this long-term)
  • Late onset side effects (researchers call this late effects)
  • Physical side effects
  • Fertility side effects

Understanding early onset vs. late onset side effects

  • Early onset side effects develop during treatment. They may be temporary or chronic, and therefore permanent.
    • Temporary effects improve or disappear over time. Examples include anemia, fatigue, hair loss and anxiety.
    • Permanent effects remain and include limb loss, some types of limb weakness, or nerve damage.

  • Late onset side effects are delayed and can surface months to years after treatment ends. Usually, the earlier these problems are identified, the easier they are to treat.
    • Some late effects are long lasting or permanent, including certain types of heart disease or lung disease, lymphedema, osteoporosis, depression, and second cancers.

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Side Effects… this is NEWS to me!

You might be surprised to learn about the wide range of side effects. Please discuss these possibilities with your doctor prior to making your treatment decisions. Some doctors do not discuss these issues in detail with their patients for the following reasons:
  • They may believe the cancer experience can be so overwhelming that too much information might cause cognitive and emotional overload.

  • Each person is unique. Therefore, some doctors do not discuss these effects because they cannot predict who will experience them.
  • Doctors are generally more focused on the acute disease state and the patient’s survival rather than the aftermath of treatments.
  • Some doctors may not be well educated about all long-term and late effects from treatments.
  • Some long-term and late effects simply are not known.

Since there are more cancer survivors today compared to five or ten years ago, the medical community is now able to collect increasing amounts of information about long-term and late effects directly from cancer survivors.

More research studies are tracking and evaluating these effects, as well as interventions to help patients.

CISN Tip:A warning against becoming over whelmed!!!

Please remember that not everyone who has cancer treatment experiences any of the side effects mentioned here and no one person experiences all of them!

Please talk with your health care team about any concerns you might have.


What cancer treatments cause side effects?

Side effects of cancer treatment have been identified in relation to the three main types of cancer treatments— surgery, radiation, and chemotherapy. Effects come from each cancer treatment in isolation, as well as the combination.

As new types of cancer treatments are widely used, side effects in cancer survivors may become apparent from other interventions. However, researchers are striving to develop treatments that not only improve survival but also lead to fewer and less serious side effects.


Damage may occur when healthy tissue surrounding the tumor is removed during surgery to increase the likelihood of getting all the cancer cells. Depending on the part of the body, surgery can damage muscles, bones, nerves and organ systems.

Of course your doctor will do all that he/she can do to prevent any side effects.

Some examples of potential early and late onset side effects from surgery include the following.

  • Scarring at the incision site

  • Lymphedema; swelling of limbs (arms or legs)

  • Problems with movement or activity

  • Nutritional problems (for example, if part of the bowel is removed)

  • Cognitive problems such as memory loss, learning disabilities in children, concentration and processing 

  • Changes in sexual function and fertility

  • Pain that may be long-term, chronic or acutely related to surgery
Psychological effects of physical changes, even if the physical changes are not visible to others (for example, feeling self-conscious about a scar from surgery, even if that scar is usually hidden by clothing).



Good News: Although side effects still occur, the risks of these effects from surgery have been reduced over the years.

  • For many types of cancer, less invasive surgery is now used, which results in less scarring than years ago.

  • Newer methods limit the damage to normal tissues, and reconstructive surgery now helps reduce noticeable physical changes from surgery.
  • Even when radical surgery is needed, advances in surgical technique and technology have dramatically reduced the damage and resulting long-term effects associated with these procedures.
  • Be sure to discuss this with your doctor. Sometimes you have several surgery options. One may have fewer side effects than another.


Even though shields are used to minimize radiation damage, side effects may happen. Permanent damage to normal cells or structures of the body may occur to areas within close proximity to radiation exposure.


Compared to chemotherapy, which is almost always systemic (throughout the body), radiation is local. It may cause both early and late onset effects, but only in the area of the body that was exposed to the radiation.


However, some radiation side effects are similar to those caused by chemotherapy.

Some examples of potential side effects from radiation include the following. Remember, not all people exhibit early onset side effects.

  • Fatigue
  • Cataracts (if radiated near eyes, cranial-spinal or Total Body Irradiation (TBI))
  • Permanent hair loss (if scalp is radiated over certain dose levels)
  • Dental decay, tooth loss, receding gums (if radiated near mouth)
  • Loss of tears and ability to produce saliva (if lacrimal or salivary glands in the face are radiated or TBI)
  • Problems with thyroid and adrenal glands (if neck radiated)
  • Slowed or halted bone growth in children (if bone radiated)
  • Effects on the pituitary gland and multiple hormonal effects related to hypothalamic-pituitary region being radiated
  • Decreased range of motion or lymphedema in the treated area
  • Skin sensitivity to sun exposure (in area of skin that was radiated)
  • Problems with the bowel system (if abdomen radiated)
  • Secondary cancers (in area radiated)
  • Heart or lung damage (for some breast cancer patients)

  • Infertility (if ovaries or testes, cranial-spinal were directly radiated or TBI)
CISN Tip: Be sure to discuss possible side effects from radiation therapy.

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