Long-term Effects Of Chemotherapy Research Articles

Long-term effects of chemotherapy in children with cancer

Background: Cancer is a non-communicable disease that poses a health problem worldwide, including in Indonesia, affecting not only adults but also children. The most commonly used cancer therapy is chemotherapy, yet it still has effects that can impact children both physically and psychologicallyPurpose: To identify the frequently experienced impacts of chemotherapy on children based on assessments conducted by parents at the "Estella" Children's Cancer Center, Prof. Dr. Kandou Hospital.Method: This research utilized a quantitative descriptive method. The sampling technique employed was consecutive sampling, involving a total of 41 respondents. The study was conducted during the period of July-August 2023. Data was gathered using the Chemotherapy-Symptom Assessment Scale (C-SAS), comprising 23 questions. Data analysis utilized frequency distribution.Results: The research findings indicated that 80.5% of children experience alopecia (hair loss), and 80% of children considered nausea and vomiting as the most disruptive physical effects of chemotherapy, with mood swings being identified as the most disruptive psychological effect.Conclusion: Parents need to pay attention to the effects of chemotherapy to enhance the quality of life for their children during their chemotherapy treatments. It is hoped that the results of this research can be utilized by parents to manage the effects of chemotherapy on pediatric cancer patients.

Long-term effects of chemotherapy in patients with acute leukemia in childhood

An increase in the survival rate of patients who had cancer in childhood determines the need to study the long-term consequences of the treatment. Long-term complications may develop from various organs and systems: active studies of the toxicity of chemotherapy are carried out in the field of pharmacogenetics, respiratory, cardiovascular, sensorineural and endocrine systems, as well as skin, central nervous system, immune system and others. The treatment of acute leukemia carried out in childhood can significantly reduce the quality of life, cause cognitive and psychoemotional disorders. Experts in the field of pediatric hematology-oncology proposed to create an indicator called «survival without pronounced toxicity». A group of scientists initiated an international project to study the outcomes of childhood malignant tumors. Among the long-term consequences, it is planned to assess the quality of life and the development of complications. The study of long-term complications of leukemia treatment will allow us to develop algorithms for the prevention and follow-up of these patients.

Long-term effect of chemotherapy after ovarian decortication on the ovarian function in women surviving cancer

PurposeOvarian decortication may affect ovarian function. We investigated the status of ovarian reserve after ovarian decortication plus chemotherapy at a stage of presumed stabilized recovery in women surviving cancer.MethodsWe searched our database for cancer survivors subjected to ovarian decortication and chemotherapy at least 3 years previously. Ovarian function was explored for levels of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2), and menstrual pattern.ResultsForty women (mean age 29.6 (SD, 6.1) years) were assessed at a mean of 4.7 (1.5) years after surgery. The predecortication levels of AMH and FSH changed at post-treatment from 2.2 (1.4) to 0.5 (1.3) ng/mL for AMH (p < 0.001) and from 4.7 (2.1) to 16.7 (21. 6) IU/L for FSH (p < 0.001). Amenorrhea consistent with primary ovarian insufficiency (POI) was diagnosed in 11 women, and normal ovarian reserve (AMH ≥ 1.0 ng/mL) was found in 4 of the 21 women who recovered regular cycles. Logistic regression confirmed AMH as an independent predictor of diminished ovarian reserve (OR = 0.24, 95% CI: 0.04-0.63, p = 0.025) and POI (OR = 0.11, 95% CI: 0.01–0.52, p = 0.027), and age was predictive of POI (OR = 1.36, 95% CI: 1.08–1.96, p = 0.035) and of irregular menstrual cycle (OR = 1.20, 95% CI: 1.03–1.46, p = 0.034).ConclusionOvarian decortication plus chemotherapy had a deleterious effect when assessed at a stage of stabilized ovarian recovery, but whether ovarian decortication had a specific impact cannot be revealed from our data.

An unusual occurrence of synchronous invasive duct carcinoma and multiple myeloma – A case report

The cancer survival rates continue to increase with the passing day owing to advances in diagnostic modalities, therapeutic strategies and the ongoing research. Simultaneously, there is also an increase in the incidence of multiple primary cancers due to the increased survival, long term effects of chemotherapy and/or radiation therapy, higher diagnostic sensitivity and the persisting effects of behavioural and genetic risk factors. Multiple Primary Malignancies (MPM) was first described in 1879 by Billroth. Multiple primary tumours are defined as synchronous or metachronous tumours presenting in the same individual. The neoplasms may be limited to a single organ or may involve multiple anatomical organs. This article presents a case study of a 72-year old female, who was referred to our institute with a history of lump in the left breast and fracture of left clavicle.

Prospective Evaluation of Kidney Function in Long-Term Survivors of Pediatric CNS Tumors.

Purpose: Numerous acute effects of chemotherapeutics on kidney function are well described. However, data on the long-term effects of chemotherapy in the growing population of childhood central nervous system (CNS) tumor survivors is limited. We aimed to evaluate the kidney function of a cohort of long-term CNS tumor survivors treated with different standard chemotherapeutic regimens. Methods: Patients treated for a CNS tumor were prospectively evaluated up to 12 years after completion of their therapy. Examination of kidney function was performed during routine follow-up visits. Blood pressure and blood and urine parameters were analyzed for kidney function evaluation. Glomerular function was assessed by calculating the estimated glomerular filtration rate (eGFR), tubular functions were analyzed by measuring serum electrolytes, bicarbonate and phosphate reabsorption, and proteinuria was assessed by calculating the protein/creatinine ratio and phosphate reabsorption. Results: None of the 65 patients evaluated suffered from clinically relevant kidney impairment (eGFR < 90 mL/min/L, 73 m2). There was no association between chemotherapy dose and eGFR. Only two patients showed mild signs of tubulopathy and 11 patients were diagnosed with elevated blood pressure. Conclusion: With adequate supportive measures, such as sufficient hydration according to chemotherapy protocol guidelines, as well as avoidance or close monitoring of additional nephrotoxic medication, impaired kidney function is rare in CNS tumor survivors treated with standard chemotherapy. Nonetheless, long-term follow-up is essential for early detection of mild impairment of kidney function.

P–434 Effect of let–7a mimic as a new pharmaco-protective agent against chemotherapy-induced ovarian damage on subsequent follicular development and oocyte quality using mouse ovarian transplantation model

Abstract Study question What is the long-term impact of let–7a-mimic transfection on oocytes development in new-born mice ovaries exposed to chemotherapy in vitro following transplantation in the kidney? Summary answer The let–7a-mimic restoration protects against chemotherapy-induced ovarian apoptosis and preserves subsequent follicular developmental and acquisition of oocyte maturation competence in mouse. What is known already It is well known that cyclophosphamide and its active metabolites (4-hydroperoxycyclophosphamide, 4-HC) cause irreversible ovarian damage and impair future fertility of cancer survivors. Besides the available fertility preservation options, microRNAs/miRNAs appear to be very attractive and novel targets to prevent theses damage. We showed that miRNAs were dysregulated after exposure to 4-HC in postnatal-day–3 (PND3) ovaries, let–7a being the most downregulated among them. By replacing let–7a function, let–7a-mimic was able to protect mouse follicles against 4-HC in vitro. This previous study suggested that it could preserve the reproductive potential after treatment. However, the impact on subsequent oocytes development is unknown Study design, size, duration PND3 ovaries from C57blxCBAF1 hybrid mice were cultured under 3 conditions: control, chemotherapy for 24h (4-HC/20μΜ/24h), chemotherapy for 24h+let–7a-mimic (4-HC/20μΜ/24h+let–7a-mimic). Nine PND3 ovaries were cultured in the different conditions and then transplanted under the kidney’s capsule of C57blxCBAF1 hybrid adult mice for follicular growth/apoptosis evaluation. Then, 21 ovaries (≥7/condition) were used for oocyte maturation assessment after transplantation and ovarian stimulation. All transplanted mice were observed during 21 days before PND3 ovaries collection. Participants/materials, setting, methods: PND3 ovaries were cultured in vitro using inserts under different conditions. A liposome-based system was used to deliver let–7a-mimic into ovaries and QPCR-assays validated its expression levels after transfection. Apoptosis was evaluated by TUNEL Assay while haematoxylin/eosin staining was used for assessing the follicular morphology, stage and count. The oocyte maturation rate was evaluated at day 21 post-transplantation after gonadotropins injection, mechanical eggs collection and in vitro maturation for 24 hours. Main results and the role of chance The apoptosis assessment confirmed that let–7a-mimic transfection reduced the chemotherapy-induced damage in PND3 ovaries in vitro. The number of primordial follicles was significantly reduced (p &amp;lt; 0.05) compared to control after chemotherapy exposure. However, it was increased in chemo24h+let–7a-mimic compared to chemo24h alone while remaining lower than control (p &amp;gt; 0.05). Accordingly, the number of the transitory follicles reflecting follicular activation was significantly higher in chemo24h compared to control (p &amp;lt; 0.05) and chemo24h+let–7a-mimic but for the last one, the result was not significant. Consequently, chemotherapy induces follicle activation while let–7a restoration tends to slow down this effect. To evaluate the long-term effects of chemotherapy and let–7a-mimic transfection, in vitro exposed PND3 ovaries were transplanted under kidney’s capsule in female adult mice. After 21 days, the ovarian reserve was higher in control, but we observed a slight increase of follicular density in the chemo24+let–7a-mimic compared to chemo24h. Similarly, the percentage of damaged/apoptotic cells was higher in all chemotherapy exposed groups compared to control but the impact was lower after let–7a restoration (12,0% and 28,2% in chemo24+let–7a-mimic and chemo24h, respectively). Importantly, the oocyte maturation rate after transplantation was higher in chemo24h+let–7a-mimic compared to chemo24h (40% versus 18%, respectively), suggesting a preservation of oocytes maturation competence. Limitations, reasons for caution The multiple in vitro/in vivo steps may introduce study bias. Moreover, the oocyte competence and live offspring is currently evaluated. The blastocyst formation and embryo development from oocytes fertilized in vitro, are more relevant parameters for oocyte quality assessment. The birth of healthy animals will confirm let–7a-mimic-transfection safety. Wider implications of the findings: Our previous study demonstrated the anti-apoptotic effect of let–7a restoration in mouse ovaries against chemotherapy. In the current study, we demonstrated a long-term beneficial effect of let–7a restoration strategy on follicular development and oocytes maturation capacity. The results open new perspectives in fertility preservation using pharmacological approach. Trial registration number Not applicable

Acute Myeloid Leukemia as Second Tumor in a Patient with Burkitt’s Lymphoma: Literature Review and a Case Report

The application of highly effective tumor treatment protocols in children and increasing number of patients healed resulted in a growing focus on long-term effects of chemotherapy. One of the most dangerous complications of a first malignant neoplasm (MN) is the development of second MNs. Cytostatic drugs of the epipodophyllotoxin group and alkylating agents contribute to secondary acute myeloid leukemias (AML), the rare and prognostically very unfavorable second MNs. The present article provides a review of literature on risks of secondary hematological MNs associated with the therapy of first tumors. It also contains a case report of successful treatment of AML which occurred after Burkitt’s lymphoma therapy.

Preparation and Evaluation of Physicochemical Properties of the Doxepin Mucoadhesive Gel

Background: Oral mucositis is a common debilitating complication of cancer chemotherapy and radiotherapy that can reduce the quality of patient’s lives. Hence, treating this condition plays an important role in increasing the patient’s tolerance. Objectives: Doxepin mucoadhesive gel is useful for treating oral mucosa inflammation caused by long-term effects of chemotherapy, which has low adverse effects. Methods: Doxepin gel’s formulation was prepared with various concentrations of poloxamer 407 and hydroxypropyl methylcellulose in deionized water. The prepared gels were evaluated for pH, appearance, viscosity, spreadability, stability, and drug release. Results: After providing gels containing doxepin, formulations 1, 2, 8, and 9 had low quality and, thus, were removed from the study. Based on qualitative evaluations, formulations 3 and 4 did not meet the criteria for mucoadhesive gel and were removed from the study. The best formulation contained 17% w/w poloxamer 407, 10% w/w hydroxypropyl methylcellulose, and 5% w/w doxepin. Conclusions: Suitable physicochemical properties of prepared doxepin mucoadhesive gel enable it to well cover inflamed and damaged oral mucosa. On the other hand, doxepin’s slow release from formulation (8 hours) can increase therapeutic effects and reduce side effects, which can heal and soothe inflammations of the oral mucosa and be useful in cancer patient’s treatment.

The chemo-brain effect in colorectal cancer patients.

e24095 Background: The chemo-brain effect associated with systemic chemotherapy results in cognitive disturbances impacting the capacity to engage in tasks and quality of life (QOL). Patients with colorectal cancer (CRC) who receive adjuvant chemotherapy generally have long survival times. The long-term effect of chemotherapy on cognition is uncertain. We aimed to ascertain the frequency of long-term cognitive impairment using neuropsychological assessments and correlating with neuroimaging. Methods: In this prospective pilot study, patients (n=22) with stage II to III CRC between 45 to 75 years old, who were planned to receive adjuvant chemotherapy, were recruited. 3 visits were scheduled for each subject – pre-chemotherapy (V1), at 1 month post chemotherapy (V2), and at 6 months post chemotherapy (V3). Serial tests were performed – the Cambridge Neuropsychological Test Automated Battery (CANTAB), QOL questionnaires (Hospital Anxiety and Depression Scale (HADS), Perceived Deficits Questionnaire (PDQ), EORTC QLQ-C30, FACT-ES), 3 item pocket smell test, functional PET/MRI brain imaging, and blood biomarker studies. Results: 18/22 subjects (13 male, 5 female) had completed tests at all 3 visits; the median age was 62 years (range 51 – 69). 9/18 had an initial decline (median -0.033) of Rapid Visual Information processing (RVP) at V2; 3/9 showed improvement to baseline at V3. 8/18 had a persistent decline in RVP scores at V3 (median -0.054). This was associated with increased HADS depression scores (mean 3.63 at V2 vs 4.63 at V1), worsening attention scores (mean 4.38 at V3 and 3.63 at V1), prospective memory scores (mean 3.75 at V3 vs 3.38 at V1), and total scores (mean 14.63 at V3 vs 13.75 at V1) on the PDQ. 7/18 had an increase in Paired Associates Learning (PAL) errors (median +6) at V2. 3/7 improved to baseline at V3, while 4/7 continued to have a persistent decline. PAL scores were not associated with worsening retrospective or prospective PDQ memory scores, changes in HADS depression or EORTC QLQ-C30 scores. There was no difference in baseline CANTAB scores for patients reporting declining vs stable QLQ-C30 scores. Conclusions: Only half of patients with initial RVP A and PAL decline improved at 6 months post chemotherapy. Further efforts should be placed to identify those at risk of poor recovery, and develop strategies to manage the chemo-brain effect. The correlation of cognitive decline with neuroimaging will be presented in the final analysis.

Ototoxicity after platinum-based chemotherapy in the treatment of melanotic neuroectodermal tumour of infancy.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare infantile tumor that originates from mesenchymal-neuroectodermal cells, the treatment of which uses platinum derivatives that can affect hearing loss. The present study evaluated the long-term effects of ototoxicity following chemotherapy with cisplatin, vincristine, cyclophosphamide, teniposide and adriamycin in a 10-year-old patient after surgical removal of a MNTI tumor at the age of 8 months. Audiometric tests (high-frequency tonal audiometry, speech audiometry, speech acoustics, tympanometry and absorbance measurements) were performed during a 10-year follow-up after receiving chemotherapy. Hearing disorders in the high-frequency range (6,000 to 16,000 Hz range) were demonstrated for both ears, indicating that these may be the long-term effects of chemotherapy with use of platinum compounds during the treatment of infants.

Cardiovascular diseases in survivors of childhood cancer.

Over the past few decades, the diagnosis and management of children with various malignancies have improved tremendously. As a result, there are an increasing number of children who are long-term cancer survivors. With improved survival, however, has come an increased risk of treatment-related cardiovascular complications that can appear decades after treatment. These problems are serious enough that all caregivers of childhood cancer survivors, including oncologists, cardiologists, and other health care personnel, must pay close attention to the short- and long-term effects of chemotherapy and radiotherapy on these children. This review discusses the effects of treatment-related cardiovascular complications from anthracyclines and radiotherapy and the methods for preventing, screening, and treating these complications.

Long Term Outcome and Immune Function After Hematopoietic Stem Cell Transplantation for Primary Immunodeficiency.

Transplantation techniques for patients with primary immunodeficiencies have improved so that survival from the procedure in many cases is >80%. However, long term complications may arise due to the use or not of conditioning agents. This may result in variable immune reconstitution, the long term effects of chemotherapy, particularly on fertility, and complications relating to the genetic disorder, unresolved by transplantation. For patients with severe combined immunodeficiency (SCID), long term T- and B-lymphocyte immune reconstitution is best achieved after pre-transplant chemotherapy. For patients who receive an unconditioned infusion of donor stem cells, the quality of immune reconstitution depends on the SCID genotype. Long term effects include chemotherapy-induced impaired fertility, and sequelae specific to the genotype. For patients with other primary immunodeficiencies, conditioning is required—sequelae related to direct effects of chemotherapy may be observed. Additional long term effects may be observed due to partial donor chimerism resulting in incomplete eradication of disease, and other geno-specific effects.

Child cancers: managing the complications of childhood chemotherapy in the adult dentition

Abstract: Young children who are unfortunate enough to suffer from a malignant disease are often treated with chemotherapy. This selectively toxic treatment keeps them alive but, in many cases, the effects on the developing dental structures can be very serious. Robust evidence is limited on how to manage the dental issues of the surviving patients later on in their lives. This article demonstrates some interesting malformations of teeth produced by the malignant disease or by the chemotherapy early in life. It offers some pragmatic ideas on solving some of these dental problems without destroying the already much reduced tooth tissue. CPD/Clinical Relevance: This article enables clinicians to appreciate the long-term effects of chemotherapy on the dental development of young cancer victims and outlines subsequent management using minimally destructive, pragmatic, bonded composite restorations.

The effect of a single injection of irinotecan on the development of enamel in the Wistar rats

Cancer is the second most frequent cause of death in children. Because the prognosis for childhood malignancies has improved, attention has now focused on long‐term consequences of cancer treatment. The immediate effects of chemotherapy on soft tissues have been well described; however, there is less information about long‐term effects of chemotherapy on the development of dental tissues. To test the association between the effect of chemotherapy on enamel development, we examined two groups of rats: one that had received an intraperitoneal dose of 200 mg/kg of irinotecan, whereas the other (control) group had received vehicle only. Rats were killed at 6, 48 and 96 hr post‐injection; the mandibles dissected out, fixed for histological evaluation and scanned for mineralization defects by Micro‐CT. Our results showed structural changes in the ameloblast layer along with a significant reduction in mineralization and thickness of enamel at 96 hr after chemotherapy. These data demonstrate that irinotecan induces structural changes in forming enamel that become apparent after anticancer chemotherapy treatment.

The effect of adjuvant chemotherapy on symptom burden and quality of life over time; a preliminary prospective observational study using individual data of patients aged ≥70 with early stage invasive breast cancer.

We aim to assess short and long term effects of chemotherapy on patient-reported quality of life (QOL) and patient versus clinician symptom reporting in older patients with breast cancer adjusted for tumour and aging parameters. In this prospective, multicentre, non-interventional, observational study, women aged ≥70years were enrolled after surgery and assigned to a TC chemotherapy (docetaxel and cyclophosphamide) group or a control group depending on their planned adjuvant treatment. Longitudinal multivariate models were used to assess the statistical and minimal clinically important difference (MCID) in the impact of TC chemotherapy over time on QOL and symptom burden adjusted for baseline aging and tumour parameters. Statistical significance was set at 5% and MCID at 10 points. In total, 57 patients were enrolled in the chemotherapy and 52 patients in the control group. Within the chemotherapy group, clinical deterioration was reported at 3months for Fatigue (17.73), Dyspnoea (17.05), Diarrhoea (12.06) and Appetite Loss (17.05) scores (all p<0.001). However, the scores had returned to baseline (or even better for Role Functioning) at year 1. No clinical deterioration was reported in the control group. Symptom scores as reported by patients were significantly (p<0.05) higher than those reported by the clinicians, even more so for Fatigue, Dyspnoea, and Pain. Our results show that symptom burden and diminished QOL in an older breast cancer population receiving adjuvant TC chemotherapy are short-lived and disappear after a while with no long-term differences compared to a similar population not receiving chemotherapy.

Long-term Peripheral Neuropathy in Breast Cancer Patients Treated With Adjuvant Chemotherapy: NRG Oncology/NSABP B-30.

The long-term effects of chemotherapy are sparsely reported. Peripheral neuropathy (PN) is one of the most frequent toxicities associated with taxane use for the treatment of early-stage breast cancer. We investigated the impact of the three different docetaxel-based regimens and patient characteristics on long-term, patient-reported outcomes of PN and the impact of PN on long-term quality of life (QOL). The National Surgical Adjuvant Breast and Bowel Project Protocol B-30 was a randomized trial comparing sequential doxorubicin (A) and cyclophosphamide (C) followed by docetaxel (T) (AC→T), concurrent ACT, or AT in women with node-positive, early-stage breast cancer. The AC→T group had a higher cumulative dose of T. PN was one of the symptoms assessed in a QOL substudy. Statistical methods included simple and mixed ordinal logistic regression and general linear models. All statistical tests were two-sided. Of 1512 patients, 41.9% reported PN two years after treatment initiation. Treatment with AT and ACT was associated with less severe long-term PN compared with AC→T (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.35 to 0.58; OR = 0.59, 95% CI = 0.46 to 0.75). Preexisting PN, older age, obesity, mastectomy, and greater number of positive nodes were also associated with higher risk of long-term PN. Patients who reported worse PN symptoms at 24 months had statistically significantly worse QOL (Ptrend < .001). The administration of docetaxel is associated with long-term PN. The lower rate of long-term PN in AT and ACT patients might be an important consideration in supporting choosing these therapies for individuals with preexisting neuropathic symptoms or other risk factors for neuropathy.

Long-term effects of childhood management of retinoblastoma using chemo-radiotherapy on dental tissues: Literature review and case report

Retinoblastoma is the most common intraocular neoplasm of childhood which is caused by a defective RB1 gene. It is detected early in life by clinical presentation including leukocoria, strabismus, glaucoma, poor visual tracking, and inflammation among others. Antineoplastic therapy that children with childhood malignancies are submitted to, have long-term effects on various tissues in the body. With timely treatment, the 5 years survival rate for retinoblastoma is reported to be 99%. Dental anomalies commonly seen in these children are characterized by disturbances in shape, size, number, and mineralization in permanent teeth. The purpose of this case report is to present long-term effects of chemotherapy and radiotherapy on dental development in a patient treated for retinoblastoma in childhood and discuss its pathogenesis. Early diagnosis of presence and severity of dental anomalies will help the dentist to plan and implement an appropriate course of dental treatment to make the survivor child's life as normal as possible.

Long-term effect of chemotherapy on ovarian function in premenopausal breast cancer.

e17682 Background: To assess effect of chemotherapy on ovarian function (defined as regular menses plus at least 1 hormone within premenopausal range) in premenopausal BC after follow up 24-month p...

Serum AMH level as a marker of acute and long-term effects of chemotherapy on the ovarian follicular content: a systematic review

Anti-Müllerian hormone (AMH) is a very sensitive indicator of the ovarian follicular content. Chemotherapeutic agents are notoriously ovariotoxic in that they damage follicles. The aim of this systematic review was to investigate the interest of serum AMH variations in determining the acute and long-term effects of chemotherapy on the ovarian reserve. According to the PRISMA guidelines, searches were conducted on PubMed for all English language articles until December 2013. Fifteen articles that focused on dynamic variations of AMH levels before and after chemotherapy were selected. Cancer patients have significantly lower AMH after chemotherapy than age-matched controls. Longitudinal studies of AMH variations before, during and after chemotherapy provide information about the degree of follicle loss for each patient according to different chemotherapy regimens. Different patterns of AMH levels during the ovarian recovery phase make it possible to discriminate between high and low gonadotoxic chemotherapy protocols. In addition, pretreatment AMH levels are shown to predict the long-term ovarian function after the end of treatment. These results may help to better understand the ovarian toxicity mechanisms of chemotherapy and to predict the degree of the ovarian follicle loss. Therefore, it can be useful for fertility preservation strategies, fertility counseling and future family planning.

Oncologists' and primary care physicians' awareness of late and long-term effects of chemotherapy: implications for care of the growing population of survivors.

The population of cancer survivors is large and growing. Yet after successful completion of treatment, many experience chemotherapy-related late or long-term effects (LEs). The extent to which physicians are aware of LEs is unknown. We conducted a nationally representative survey of 1,130 oncologists and 1,072 primary care providers (PCPs). Respondents were asked to select the LEs they had either observed or seen reported for five chemotherapy agents used to treat breast and colon cancers. We described and compared oncologists' and PCPs' awareness of the specified LEs. Using multivariate logistic regression models, we determined predictors of physicians' awareness of the main LEs associated with the agents. Almost all oncologists (95%) reported awareness of cardiac dysfunction as an LE of doxorubicin and peripheral neuropathy as an LE of paclitaxel (97%) and oxaliplatin (97%). These LEs were reported by 55%, 27%, and 22% of PCPs, respectively. Most oncologists reported awareness of premature menopause (71%) and secondary malignancies (62%) as LEs of cyclophosphamide, compared with only 15% and 17% of PCPs, respectively. Main LEs associated with all four agents were identified by 65% of oncologists and only 6% of PCPs. Although more than half of PCPs were aware of cardiac dysfunction as an LE of doxorubicin, awareness of other LEs was limited. Because PCPs may not be directly exposed to chemotherapy-related LEs, oncologists must communicate this information to PCPs as patients transition to primary care settings. Education for all providers caring for the growing population of cancer survivors is needed.