TESTING
HEART AND LUNG EFFECTS
VARIOUS TOPICS
RENAL / URINARY OR BOWEL EFFECTS
CANCER RELATED EFFECTS
100
A test that looks at the size and function of the heart A test that looks at the electrical activity of the heart
What is a ECHOCARIOGRAM / EKG (electrocardiogram). Used to monitor the heart after recieving anthracycline chemotherapy or radiation to the chest.
100
A vitamin I can take that helps my cholesterol
What is FISH OIL
100
This is a clouding of the lens of the eye due to exposure to steroids or radiation.
What are cataracts? Cataracts can develop decades after exposure so yearly eye exams are necessary.
100
A simple test to screen for blood or protein in the urine.
What is a urinanlysis? If you have had toxic medications to the kidneys, protenuria can be a sign of renal damage that needs to be monitored. It is most common in patients recieving cisplatin / carboplatin / ifofamide. If you have had cytoxan (higher doses), ifosfamide or hemorrhagic cystitis, a urine should be done each year to screen for bladder cancer.
100
A potential late effect on the bone marrow after chemotehrapy like etoposide / busulfan / cytoxan and radiation.
What is Leukemia or myelodysplasia. While that risk is low, a CBC should be done each year or with prolonged illness. The greatest risk is within 10 years of therapy but late development has occured.
200
Blood test that should be followed starting around puberty to help doctors know if your testes and ovaries are working well after therapy.
What are FSH, LH, Testosterone, Estrogen. Starting around age 12 in girls and age 13 in boys. These hormones tell us about your testes and ovarian function. Why is this important?
200
An excellent exercise to improve or preserve my lung function.
What is Swimming? Helps with gas exchange, oxygenation and muscle strength
200
What medicine can be prescribed to help me grow?
What is growth hormone? This is a daily injection that can be administered at home. It must be started before your growth plates close. It may help you grow additional inches. However, it can be hard on the kidneys.
200
A side effect of steroids, tacrolimus, cyclosporine and other renal toxic medications. This is an adult disease that runs in families and happens earlier in survivors of childhood cancer.
What is hypertension (high blood pressure)? Usually the high blood pressure resolves once the medications are discontinued. However, you should continue to have your blood pressure monitored everytime you go to the doctor. You are at risk for having it come back again in survivorship, earlier than your family members may have developed it.
200
A potential cancer following radiation to the neck area.
What is thyroid cancer. An ultrasound of the thyroid should be done every 3 years following radiation as a screening test.
300
Hormones levels and other studies that should be monitored to see if chemotherapy affected your ability to grow
What are TSH, Free T4, Cortisol, Growth hormone, bone age, growth curves? These can be helpful to know if your body needs replacement hormones to help your body function to the best of its ability. Thyroid should be checked every year even once you are at your adult height. If you have been on inhaled or oral steroids, you should have your cortisol followed for new symptoms of fatigue even after your adult height is obtained.
300
A lung test that is that quantifies your lung capacity, gas exchange and airways
What is a pulmonary function test? If you have had chest radiation, total body radiation, BCNU, Bleomycin or Busulfan, this test should be done at least once a year until 2 years post therapy. If you have graft vs host disease after transplant, it should be followed more closely (every 1-3 months). If you snore or feel alot of fatigue and are on medicines for your lungs, consider an overnight pulse oximetry to look for low oxygenation when you sleep.
300
This is a problem that can cause you to have pain in the joints, that is worse with activity, especially if you have had steroids.
What is avascular necrosis? A MRI can look at the blood supply to your bones. Exercise / supportive care / joint replacement surgery are the therapies.
300
A blood pressure medicine that can be used to protect my kidneys if I develop protein leaking kidneys.
What is an ACE inhibitor? Survivors can develop chronic renal dysfunction years after chemotherapy and radiation exposure. Growth hormone and growth during regular puberty can be stressors. Poor hydration or ongoing renal toxic medications increase the late effect incidence.
300
A late effect of the skin following radiation and graft vs host disease of the skin?
What is skin cancer? A Dermatologist can map your moles and follow them every year. Sunscreen is very important and should be applied several times a day.
400
Tthe tests that help to follow the health of my bones
What are calcium, vitamin D, DEXA scan Dexa scan looks at the thickness of the bones and can warn you and your doctor if you are at risk for developing fractures. Most young adults should be on 1200mg of Calcium a day and 2000units of Vitamin D a day. Higher weekly doses of 50,000units once to twice a week may be prescribed for Vit D deficiency.
400
Potential long term effects on the heart.
What are: thickend heart muscle, decreased heart function, irregular heart rhythms and valve disease. Those with anthracycline> 300mg/m2 and radiation exposure are at highest risk. Control of blood pressure is very important. Take chest pain seriously. Good aerobic exercise three times a week is excellent for prevention.
400
If you have had vincristine, cisplatin, taxanes, carboplatin this can cause___________ which is numbness/tingling/pain in the fingers/toes or dizziness (vertigo).
What is peripheral neuropathy? If it is painful, medication against nerve pain can be used. You must be careful to protect your fingers/toes against injury if they are numb. Occupational therapy may help you if you have a hard time using your hands for daily activities.
400
A common urinary problem after surgery or radiation of the abdomen, often embarrassing the the person. Also a very common problem after women have children.
What is urinary incontinence? Where the bladder has a hard time holding in urine and you can have leakage with jumping, running, laughing. Emptying your bladder on a schedule can be helpful. Taking medication to help with bladder compliance (like ditropan or pseudoephedrine) can be helpful.
400
A cancer that can occur in girls following chest radiation (especially those treated for hodgkins disease or who have had total body irradiation with bone marrow transplant).
What is Breast Cancer? Mammogram and MRI of the breast should begin 8 years following exposure or by age 25 which ever occurs last. Self-breast exams are recommended monthly.
500
Evaluations that should be followed if I develop headaches followed chemotherapy (Methotrexate / intrathecal chemotherapy or radiation)
What are MRI, stress, anxiety, processing problems in school
500
A syndrome of high blood pressure, high cholesterol, central obesity, diabetes and early heart disease
What is Metabolic Syndrome? People at greatest risk are those who have been treated for ALL / AML and those who have had bone marrow transplant.
500
This is a side effect of medications like carboplatin / cisplatin / lasix / certain antibiotics affecting the ears.
What is hearing loss? Audiological evaluation should be done at least one year after completion of therapy (sooner if there are concerns). Limiting noise exposures and ototoxic medications is important.
500
A problem when you have had vincristine, radiation or graft vs host disease of the gut.
What is irritable bowel syndrome? Can be constipation due to slowed gut motility. requires a bowel regimen to keep your stools regular (MIRALAX plus/minus a stimulant) Can be diarrhea due to poor absorption (Fiber and a diet low in gluten or dairy can be helpful).
500
A potential cancer following radiation that you or your dentist may notice.
What is oral cancer? If you have a non-healing sore in the mouth and you have had radiation, this should be biopsied to rule out a secondary cancer. As with any cancer, catching it early is the best prognosis. While it is scary to talk about new cancers, we MUST be watchful so they can be irradicated as soon as possible!
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