The most frequently observed medical late effects, however, include endocrine complications, growth hormone deficiency, primary hypothyroidism and primary ovarian failure (10,11,13).
Late effects can be classified further as system specific (such as damage, failure or premature aging of organs; immunosuppression or compromised immune systems; and endocrine damage), second malignant neoplasms (such as an increased risk of recurrent malignancy, a certain cancer associated with the primary cancer and a second cancer associated with cytotoxic or radiological cancer therapies) and functional changes (such as lymphedema, incontinence, pain syndromes, neuropathies and fatigue); cosmetic changes (such as amputations, ostomies and skin and hair alterations); and associated comorbidities (such as osteoporosis, arthritis, scleroderma and hypertension) (4,10,11,30). The spectrum of late and long-term complications ranges from minor and treatable to serious and
lethal (11,13).