Surgical removal of a tumour can leave behind cosmetic changes or handicaps that are directly related to the location of the surgery. Children with brain tumours may have significant damage to their brain at diagnosis.

The surgeon may have to remove some normal brain tissue to completely remove a tumour. This may result in problems with sight, speech, hearing, movement, strength, learning, hormone or fluid/salt imbalance and seizures depending on the location and extent of damage. Some of these effects may become obvious only as the child grows or starts school, and may be worsened by radiation.

Children will require periodic assessment for at least one year to detect such problems and commence rehabilitation or hormone replacement if necessary. Prior to starting school they should again have detailed assessment for the early detection of learning disabilities so that they may receive special education if necessary.

Surgery of structures around the face may require reconstruction and correction of deformities later for cosmetic reasons. Bone tumours in the arms or legs may require amputation or tumour removal and the use of external or internal prostheses that have to be adjusted with growth. Bone damage and growth will need to be closely monitored.

Removal of tumours without amputation may result in weakness, restriction of movement or decreased growth of a limb. Close medical observation and intervention are necessary.

Removal of the stomach, pancreas or intestines may require diet modifications if absorption and digestion of food or essential vitamins is affected. Surgery in the abdomen and pelvis can result in late hernias, adherence, obstruction and twisting of the gut causing pain and other bowel symptoms. Removal of the spleen makes patients susceptible to bacterial infections that could become serious and needs timely care.

Side effects of surgery will become apparent immediately after surgery so that the necessary intervention can be planned early. Occasionally surgery can cause late problems (a few months later), such as narrowing/tethering of the intestines (abdominal surgery) resulting in vomiting, constipation or pain, decreased food intake or absorption/diarrhoea, etc. and will need to be treated by a doctor.

Late side effects

The side effects described below develop gradually over a period of time.

They are related to radiation, chemotherapy or bone marrow transplantation. Radiation therapy: The dose, extent and location of radiation determine side effects.