The word “this” (L25) refers back to:

    Chemo and radiation cause similar side effects. Chemo's side effects depend on the type of drug used, the dosage, and a child's overall health. These effects are more likely to affect the whole body. Radiation's side effects, on the other hand, tend to affect the area being treated. But they do still depend on the dose of radiation given, the location on the body, and whether the radiation was internal or external. Some of them are: fatigue, flu-like symptoms, pain, gastrointestinal problems, skin and weight changes, hair loss, kidney and bladder problems, anemia, blood clotting problems, neutropenia, infection. Besides that both chemo and radiation — specifically to the head and neck — can lead to mouth sores, sensitive gums, an irritated throat, and an increased risk of tooth decay.

    Kids with neutropenia need to take special precautions against germs. Like all kids, they should wash their hands well and often, especially before eating, after using the bathroom, and after touching animals. They also need to avoid crowded indoor places or visiting with friends or family members who have contagious illnesses such as a cold, the flu, or chickenpox.

    Cells that help blood to clot, called platelets, are another type of blood cell that can be affected during cancer treatment, especially chemo. Low platelets, orthrombocytopenia, can lead to bleeding. This may cause small red spots on the skin, bloody or black bowel movements, vomit, or bleeding from the nose, gums, or line site (the area where fluids and medicines are given to people with cancer). Kids with a low platelet count have to take it easy to reduce the risk of bleeding. That means avoiding rough play and contact sports (like football), and brushing with a soft toothbrush and flossing very gently. In very serious cases of thrombocytopenia, a child might need a blood transfusion.

    Most side effects start to go away after cancer treatment ends and the healthy cells have a chance to grow again. Sometimes, though, cancer treatment can cause changes to a growing body. These long-term side effects can include permanent damage to the heart, lungs, brain, nerves, kidneys, thyroid gland, or reproductive organs. In some cases, kids and teens who’ve had some types of chemotherapy have a higher risk of developing a second type of cancer later in life. Cancer treatment has come a long way. But it can be hard for kids and teens to cope with the sometimes painful or uncomfortable side effects of treatment. Fortunately, doctors have many ways to make treatments easier to manage.

(Available: https://kidshealth.org. Adapted.)