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Late Effects of Treatment for Childhood Cancer (PDQ®)

Patient Version
Last Modified: 01/11/2012

Urinary System

Key Points for This Section


Kidney

Certain chemotherapy drugs increase the risk of kidney late effects.

The risk of health problems that affect the kidney increases after treatment with the following:

The following may also increase the risk of kidney late effects:

Late effects that affect the kidney may cause certain health problems.

Kidney late effects include the following:

Possible signs of kidney late effects include changes in urination and swelling of the feet or hands.

These symptoms may be caused by kidney late effects:

  • Feeling the need to urinate without being able to do so.
  • Frequent urination (especially at night).
  • Trouble urinating.
  • Feeling very tired.
  • Swelling of the legs, ankles, feet, face, or hands.
  • Itchy skin.
  • Nausea or vomiting.
  • A metal-like taste in the mouth or bad breath.
  • Headache.

Sometimes there are no symptoms in the early stages. Symptoms may appear as damage to the kidney continues over time. Other conditions may cause the same symptoms. Talk to your doctor if you have any of these problems.

Certain tests and procedures are used to detect (find) and diagnose health problems in the kidney.

These and other tests and procedures may be used to detect or diagnose kidney late effects:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Blood chemistry study: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as magnesium, calcium, and potassium, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance may be a sign of kidney disease.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
  • Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
  • Twenty-four-hour urine test: A test in which urine is collected for 24 hours to measure the amounts of certain substances. An unusual (higher or lower than normal) amount of a substance, such as protein, urea nitrogen, or creatinine, can be a sign of disease in the organ or tissue that makes it.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the kidney, and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.

Talk to your doctor about whether you need to have tests and procedures to check for signs of kidney late effects. If you do, find out how often they should be done.

Health habits that promote healthy kidneys are important for survivors of childhood cancer.

Childhood cancer survivors who had all or part of their kidney removed should talk to their doctor about the following:

  • Whether it is safe to play sports that have a high risk of heavy contact or impact such as football or hockey.
  • Bicycle safety and avoiding handlebar injuries.
  • Wearing a seatbelt around the hips, not the waist.

Bladder

Surgery to the pelvic area and certain chemotherapy drugs increase the risk of bladder late effects.

The risk of health problems that affect the bladder increases after treatment with the following:

  • Surgery to remove all or part of the bladder.
  • Surgery to the pelvis or brain.
  • Certain chemotherapy drugs, such as cyclophosphamide or ifosfamide.
  • Radiation therapy to areas near the bladder or urinary tract.

Late effects that affect the bladder may cause certain health problems.

Bladder late effects include the following:

Possible signs of bladder late effects include changes in urination and swelling of the feet or hands.

These symptoms may be caused by bladder late effects:

  • Feeling the need to urinate without being able to do so.
  • Frequent urination (especially at night).
  • Trouble urinating.
  • Feeling like the bladder does not empty completely after urination.
  • Swelling of the legs, ankles, feet, face, or hands.
  • Little or no bladder control.
  • Blood in the urine.

Other conditions may cause the same symptoms. Talk to your doctor if you have any of these problems.

Certain tests and procedures are used to detect (find) and diagnose health problems in the bladder.

These and other tests and procedures may be used to detect or diagnose bladder late effects:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Blood chemistry study: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as magnesium, calcium, and potassium, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance may be a sign of bladder problems.
  • Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the kidney and bladder, and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.

Talk to your doctor about whether you need to have tests and procedures to check for signs of bladder late effects. If you do, find out how often they should be done.



Glossary Terms

abnormal (ab-NOR-mul)
Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
bladder (BLA-der)
The organ that stores urine.
blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
blood chemistry study (blud KEH-mih-stree STUH-dee)
A procedure in which a sample of blood is examined to measure the amounts of certain substances made in the body. An abnormal amount of a substance can be a sign of disease in the organ or tissue that produces it.
calcium (KAL-see-um)
A mineral needed for healthy teeth, bones, and other body tissues. It is the most common mineral in the body. A deposit of calcium in body tissues, such as breast tissue, may be a sign of disease.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
carboplatin (KAR-boh-pla-tin)
A drug that is used to treat advanced ovarian cancer that has never been treated or symptoms of ovarian cancer that has come back after treatment with other anticancer drugs. It is also used with other drugs to treat advanced, metastatic, or recurrent non-small cell lung cancer and is being studied in the treatment of other types of cancer. Carboplatin is a form of the anticancer drug cisplatin and causes fewer side effects in patients. It attaches to DNA in cells and may kill cancer cells. It is a type of platinum compound. Also called Paraplatin.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
cisplatin (sis-PLA-tin)
A drug used to treat many types of cancer. Cisplatin contains the metal platinum. It kills cancer cells by damaging their DNA and stopping them from dividing. Cisplatin is a type of alkylating agent.
complete blood count (kum-PLEET blud kownt)
A test to check the number of red blood cells, white blood cells, and platelets in a sample of blood. Also called blood cell count and CBC.
condition (kun-DIH-shun)
In medicine, a health problem with certain characteristics or symptoms.
creatinine (kree-A-tih-neen)
A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function.
cyclophosphamide (SY-kloh-FOS-fuh-mide)
A drug that is used to treat many types of cancer and is being studied in the treatment of other types of cancer. It is also used to treat some types of kidney disease in children. Cyclophosphamide attaches to DNA in cells and may kill cancer cells. It is a type of alkylating agent. Also called CTX and Cytoxan.
Denys-Drash syndrome (deh-NEES-drash SIN-drome)
A rare disorder that causes kidney failure before age 3, abnormal development of the sexual organs, and, in most cases, Wilms tumor (a type of kidney cancer). Children with Denys-Drash syndrome are also at high risk of some other types of cancer. Also called DDS.
diagnosis (DY-ug-NOH-sis)
The process of identifying a disease, such as cancer, from its signs and symptoms.
drug (drug)
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
electrolyte (ee-LEK-troh-lite)
A substance that breaks up into ions (particles with electrical charges) when it is dissolved in water or body fluids. Some examples of ions are sodium, potassium, calcium, chloride, and phosphate. These ions help move nutrients into cells, help move waste out of cells, and help nerves, muscles, the heart, and the brain work the way they should.
genetic (jeh-NEH-tik)
Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.
genitourinary system (jeh-nih-toh-YOOR-ih-nayr-ee SIS-tem)
The parts of the body that play a role in reproduction, getting rid of waste products in the form of urine, or both.
hemoglobin (HEE-moh-GLOH-bin)
The substance inside red blood cells that binds to oxygen in the lungs and carries it to the tissues.
hemorrhagic cystitis (HEH-muh-RA-jik sis-TY-tis)
A condition in which the lining of the bladder becomes inflamed and starts to bleed. The blood can be seen in the urine. Symptoms include pain and a burning feeling while urinating, feeling a need to urinate often, and being unable to control the flow of urine. Hemorrhagic cystitis may be caused by anticancer drugs, radiation therapy, infection, or being exposed to chemicals, such as dyes or insecticides.
hypertension (HY-per-TEN-shun)
A blood pressure of 140/90 or higher. Hypertension usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called high blood pressure.
ifosfamide (i-FOS-fuh-mide)
A drug that is used with other drugs to treat germ cell testicular cancer that did not respond to previous treatment with other drugs. It is also being studied in the treatment of other types of cancer. Ifosfamide attaches to DNA in cells and may kill cancer cells. It is a type of alkylating agent and a type of antimetabolite. Also called Ifex.
incontinence (in-KON-tih-nents)
Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence).
inflammation (IN-fluh-MAY-shun)
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
kidney (KID-nee)
One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.
late effects (layt eh-FEKTS)
Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.
magnesium (mag-NEE-zee-um)
In medicine, a mineral used by the body to help maintain muscles, nerves, and bones. It is also used in energy metabolism and protein synthesis.
medical history (MEH-dih-kul HIH-stuh-ree)
A record of information about a person’s health. A personal medical history may include information about allergies, illnesses, surgeries, immunizations, and results of physical exams and tests. It may also include information about medicines taken and health habits, such as diet and exercise. A family medical history includes health information about a person’s close family members (parents, grandparents, children, brothers, and sisters). This includes their current and past illnesses. A family medical history may show a pattern of certain diseases in a family.
methotrexate (meh-thuh-TREK-sayt)
A drug used to treat some types of cancer, rheumatoid arthritis, and severe skin conditions, such as psoriasis. Methotrexate stops cells from making DNA and may kill cancer cells. It is a type of antimetabolite. Also called amethopterin, MTX, and Rheumatrex.
nausea (NAW-zee-uh)
A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.
organ (OR-gun)
A part of the body that performs a specific function. For example, the heart is an organ.
oxygen (OK-sih-jen)
A colorless, odorless gas. It is needed for animal and plant life. Oxygen that is breathed in enters the blood from the lungs and travels to the tissues.
pelvis (PEL-vus)
The lower part of the abdomen, located between the hip bones.
physical examination (FIH-zih-kul eg-ZA-mih-NAY-shun)
An exam of the body to check for general signs of disease.
platelet (PLAYT-let)
A tiny piece of a cell found in the blood that breaks off from a large cell found in the bone marrow. Platelets help wounds heal and prevent bleeding by forming blood clots. Also called thrombocyte.
potassium (puh-TA-see-um)
A metallic element that is important in body functions such as regulation of blood pressure and of water content in cells, transmission of nerve impulses, digestion, muscle contraction, and heartbeat.
protein (PROH-teen)
A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
red blood cell (red blud sel)
A cell that carries oxygen to all parts of the body. Also called erythrocyte and RBC.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stem cell transplant (stem sel tranz-plant)
A method of replacing immature blood-forming cells in the bone marrow that have been destroyed by drugs, radiation, or disease. Stem cells are injected into the patient and make healthy blood cells. A stem cell transplant may be autologous (using a patient’s own stem cells that were saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin).
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
survivor (ser-VY-ver)
One who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
syndrome (SIN-drome)
A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
ultrasound (UL-truh-SOWND)
A procedure in which high-energy sound waves are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.
urea nitrogen (yoo-REE-uh NY-troh-jen)
Nitrogen in the blood that comes from urea (a substance formed by the breakdown of protein in the liver). The kidneys filter urea out of the blood and into the urine. A high level of urea nitrogen in the blood may be a sign of a kidney problem. Also called blood urea nitrogen and BUN.
ureter (YER-eh-ter)
The tube that carries urine from the kidney to the bladder.
urethra (yoo-REE-thruh)
The tube through which urine leaves the body. It empties urine from the bladder.
urinalysis (YOOR-ih-NA-lih-sis)
A test that determines the content of the urine.
urinary tract (YOOR-ih-NAYR-ee trakt)
The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra.
urine (YOOR-in)
Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.
vomit (VAH-mit)
To eject some or all of the contents of the stomach through the mouth.
WAGR syndrome (... SIN-drome)
A rare, genetic disorder that is present at birth and has two or more of the following symptoms: Wilms tumor (a type of kidney cancer); little or no iris (the colored part of the eye); defects in the sexual organs and urinary tract (the organs that make urine and pass it from the body); and below average mental ability. This syndrome occurs when part of chromosome 11 is missing. Also called Wilms tumor-aniridia-genitourinary anomalies-mental retardation syndrome.
white blood cell (hwite blud sel)
A type of immune cell. Most white blood cells are made in the bone marrow and are found in the blood and lymph tissue. White blood cells help the body fight infections and other diseases. Granulocytes, monocytes, and lymphocytes are white blood cells. Also called leukocyte and WBC.