Late side effects are those that first occur at least 6 months after radiation therapy is over. Late side effects are rare, but they do happen. It is important to have follow-up care with a radiation oncologist or nurse practitioner for the rest of your life.

Whether you get late side effects will depend on:

• The part of your body that was treated
• The dose and length of your radiation therapy
• If you received chemotherapy before, during, or after radiation therapy

Your doctor or nurse will talk with you about late side effects and discuss ways to help prevent them, symptoms to look for, and how to treat them if they occur.

Some late side effects are brain problems, infertility, joint problems, lymphedema, mouth problems, and secondary cancers.

Brain Changes

What they are

Radiation therapy to the brain can cause problems months or years after treatment ends. Side effects can include memory loss, problems doing math, movement problems, incontinence, trouble thinking, or personality changes. Sometimes, dead tumor cells can form a mass in the brain, which is called radiation necrosis.

Ways to manage

You will need to have check-ups with your doctor or nurse for the rest of your life. If you have symptoms, you will have tests to see whether they are due to the cancer or late side effects.

If you have late side effects, your doctor or nurse practitioner:

• Will talk with you about ways to manage late side effects
• May refer you to a physical, occupational, or speech therapist who can help with problems caused by late side effects
• May prescribe medicine or suggest surgery to help with the symptoms

Infertility

What it is

For men, infertility means not being able to get a woman pregnant. For women, it means not being able to get pregnant.

Ways men with infertility can become a parent:

• Donor sperm. This means getting a woman pregnant with sperm given by another man.
• Adoption. Taking on legal responsibility for someone else's child and raising the child as your own.

Ways women with infertility can become a parent:

• Donor embryos. Another couple donates a fertilized egg that your doctor implants in your uterus to carry until birth.
• Donor eggs. An egg (donated by someone else) is fertilized by your partner's sperm. Your doctor implants the fertilized egg in your uterus to carry until birth.
• Surrogacy. Another woman carries and gives birth to your child. She can also donate her egg, which is fertilized by your partner's sperm.
• Adoption. Taking on legal responsibility for someone else's child and raising the child as your own.

Joint Changes

What they are

Radiation therapy can cause scar tissue and weakness in the part of the body that was treated. This can lead to loss of motion in your joints, such as your jaw, shoulders, or hips. Joint problems can show up months or years after radiation therapy is over.

Ways to manage

Notice early signs of joint problems. These signs include:

• Trouble getting your mouth to open wide
• Pain when you make certain movements, such as reaching over your head or putting your hand in a back pocket

Talk with your doctor or nurse. He or she may refer you to a physical therapist who will assess your joint problems. The therapist can give you exercises to decrease pain, increase strength, and improve movement.