When you're a kid treated for cancer, you're often treated with very intense therapies such as radiation, chemotherapy, surgery, and blood and marrow transplants. Those therapies need to be strong enough to destroy the cancer cells in your body, and sometimes they also can damage healthy cells in the process.

Cancer treatment can sometimes lead to "late effects" in survivors. Late effects are side effects that aren't necessarily present right away but can become apparent several months or years after treatment has ended.

About 40 percent of survivors don't face any special concerns as a result of their cancer and treatment, says Daniel Mulrooney, M.D., M.S., director of the Long-Term Follow-Up Clinic, which is operated by University of Minnesota Physicians. That means that about 60 percent experience at least one late effect, although severity varies from person to person.

According to the National Cancer Institute (NCI), 62.3 percent of childhood cancer survivors reported at least one chronic condition as a result of their treatment. Just over 37 percent reported two chronic conditions, while about 24 percent reported three or more chronic conditions.

Late effects of childhood cancer treatment can take on several forms:

• Medical — These most commonly include hormone-related issues, cardiovascular disease, visual or hearing impairment, musculoskeletal problems, and secondary cancers.
• Neurocognitive — These can include problems with learning, memory, thinking, and attention.
• Emotional and Social — These can include difficulty reintegrating into school or family after treatment, depression, anxiety, and post-traumatic stress or growth.

About one-fourth of childhood cancer survivors reported having a severe, disabling, or life-threatening late effect, according to the NCI. Survivors of bone tumors, tumors of the central nervous system, and Hodgkin's disease and those who had undergone combination therapies that involved chest, abdominal, and pelvic radiation were at the highest risk of severe late effects, the NCI reports.

The impact late effects can have on a survivor's life varies greatly depending on several factors, including the person's age at treatment, type of treatments received, type of cancer, location of the cancer in the body, genetic factors, and other health conditions the person may have faced before cancer.

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The Growing Up After Cancer section of the Masonic Cancer Center Web site was produced by University of Minnesota School of Journalism and Mass Communication graduate student Nicole Endres. The section's medical content was written under the advisement of Masonic Cancer Center member Joseph Neglia, M.D., M.P.H.