ABSTRACT
This chapter addresses the potential late effects from systemic therapies and radiotherapy. Late effects, whether physical, psychological or social, are often most apparent in those treated with adjuvant intent due to their longer life expectancy compared with those on a palliative pathway. Delayed irreversible anthracycline-related cardiomyopathy may develop several months after treatment1 and manifests by signs of cardiac failure and a drop in ejection fraction. Impact on ovarian function is dependent on age, baseline fertility and cytotoxic intensity and dose. Referral to the fertility team for consideration of egg harvesting/embryo freezing should be considered where fertility preservation is desired. Zoladex may be given to down-regulate ovarian activity during chemotherapy, thus better preserving fertility and reducing a premature menopause. Although second malignancies may occur sporadically in cancer survivors due to environmental or genetic factors, there is a small added risk of treatment-induced second malignancies with adjuvant treatment.
