Will my child have side effects?

This is one of the most frequent questions we hear from parents and young people starting lymphoma treatment. The short answer is yes: There will be some side effects. The good news is that at MSK Kids, we tailor every child’s care plan to include the most-effective therapies balanced with the fewest side effects. Our goal is to eliminate the cancer while maintaining your child’s quality of life. We want kids with cancer to be able to do the things that kids like to do.

Your child’s care team will explain the possible side effects of each treatment so you’ll know what to expect. MSK Kids specialists will support your child every step of the way — in body, mind, and soul. Here are some examples of the side effects we see in children receiving lymphoma treatment.

Low Blood Counts

The chemotherapy drugs we use to kill lymphoma cells can also kill healthy cells, including white blood cells (which fight infection), red blood cells (which carry oxygen), and platelets (which stop bleeding).

• Low white blood cell counts can raise the risk of infection. We’ll speak with you about steps to take to reduce your child’s exposure to infections during this time.
• Low red blood cell counts can cause anemia. Not having enough red blood cells can make your child feel tired or short of breath, or have a faster heart rate. We treat some children with anemia using a blood transfusion. MSK has its own blood bank and donor room, and very safe blood supplies.
• Low platelet counts raise the risk of bruising and bleeding. We’ll teach your child techniques to prevent injuries. Some children receive transfusions of platelets to reduce bleeding risk. Your child should avoid taking medicines with aspirin or ibuprofen because they prevent platelets from working and increase the risk of bleeding.

Will my child lose their hair?

Your child’s doctor will let you know if the treatments can cause hair loss, which typically starts two to three weeks after starting chemotherapy. We understand how distressing this can be for parents and patients, especially teenagers. Help and support are available. You and your child can speak with former patients about the process of losing and regaining their hair. We can also help you find wigs, hats, and scarves for your child to use, if desired, until their hair grows back.

Other Side Effects of Chemotherapy

Chemotherapy can also cause:

• fatigue (tiredness)
• nausea and vomiting
• diarrhea or constipation
• a change in the taste of foods
• abnormal sensations in the fingers and toes
• poor balance
• uncomfortable mouth ulcers and irritation in the mouth and digestive tract, which we can help you manage with special oral care routines, pain medications, and modified diets

Emotional Side Effects

The process of cancer treatment can be a very challenging time for your child, you, and everyone in your family. It’s not unusual for children with cancer to regress, acting younger than their age and acting out. Siblings may not understand that your family now needs to focus much more attention on the needs of your child with cancer. You may feel stressed trying to balance your child’s healthcare with work, care for your other children, and even caregiving for other adults in your family.

The support team at MSK Kids understands what you, your child, and your family are feeling. We are available to help from the moment you walk through our doors until your child finishes the last treatment and beyond. Our social workers, psychiatrists, psychologists, play therapists, child life specialists, clergy, and volunteers can help you and your child cope with the ups and downs of the cancer journey, no matter how long that journey is. We can also arrange for you to speak with patients who had a similar treatment experience and successfully overcame their disease. There is strength in numbers. You may find comfort in knowing you are not alone.

How will my child keep up with school?

Even though your child is receiving cancer treatment, they can continue their schoolwork. A branch of the New York City public school system, called PS 401, is assigned to MSK Kids. Teachers are available daily to help children keep up with their studies, whether they are being treated in the Pediatric Ambulatory Care Center or as inpatients in Memorial Hospital.