STROKE

This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.

A stroke

The human brain is very complex and has many functions. For example, the brain allows us to move, speak, think and feel, and controls processes that happen within the body. The brain needs oxygen, which is carried in the blood through the blood vessels.

Sometimes problems can occur when a blood vessel in the brain bursts or is (partly) blocked. This can stop oxygen from reaching certain areas of the brain. When this happens, this is called a stroke.

A stroke is very rare in young people.

Am I at higher risk of a stroke?

Anyone, including people who have never had cancer treatment, has a slight chance of having a stroke during their lifetime. However, there are some cancer treatments that may increase the risk of having a stroke later in life.

The following treatment can increase the risk of a stroke:

  • Radiotherapy to the head, brain or neck or an area that includes the head, brain or neck

You can find out if you have received radiotherapy to the head, brain or neck by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, contact your treating hospital.

If you experience a stroke, it does not always mean that it was caused by your cancer treatment. A stroke may have other causes, such as high blood pressure, being overweight, diabetes, high cholesterol, smoking and older age. For more information on high blood pressure, overweight and obesity, diabetes and dyslipidemia please read: Hypertension, overweight and obesity, impaired glucose metabolism and diabetes and dyslipidemia. If a stroke is common in your family, this can also increase your risk of having a stroke.

What are the symptoms and signs of a stroke?

There are symptoms and signs that can tell you if you might have a stroke. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

The symptoms and signs of a stroke depend on which parts of the brain receive too little oxygen. Therefore, the symptoms can vary from person to person.

These symptoms and signs may suggest that you have had a stroke:

  • Sudden numbness or weakness in your face (one side of your face droops)
  • Sudden numbness or weakness in your arm or leg, especially on one side of your body. You cannot raise your arm fully and/or you cannot hold or squeeze something.
  • Difficulty speaking normally (your words are slurred)
  • Trouble seeing clearly
  • A sudden, very bad headache unusual for you that does not have a known cause such as a migraine

The word F.A.S.T. can help you remember the most important signs of a stroke:

  • F = Face Drooping
  • A = Arm Weakness
  • S = Speech Difficulty
  • T = Time to call an ambulance

What happens if I experience symptoms and signs of a stroke?

Symptoms and signs of a stroke can be sudden. If you experience symptoms or signs suddenly and you feel very sick, this is a medical emergency. Call the emergency services immediately. If you are not able to make the call yourself, ask someone else to make the call for you. If you are having a stroke, time is vitally important.

Sometimes symptoms and signs of a stroke can disappear after a few minutes or a few hours. This could mean that you experienced a transient ischemic attack (TIA), also known as a mini-stroke. A blood vessel was only blocked for a few hours, after which the blood could flow again.

If you experience any symptoms or signs of a stroke and they are mild, it does not automatically mean that you have a stroke. However, it is important to seek medical advice soon, also when the signs and symptoms disappear after a few minutes or a few hours. Your physician or follow-up care specialist may then refer you to a:

  • Neurologist (physician specialised in the brain and spinal cord)
  • Neurosurgeon (surgeon specialised in the brain and spinal cord)
  • Vascular specialist (physician specialised in blood vessels)

What else can I do?

It is important that you are aware of the possibility of having a stroke and that you know the symptoms and signs.

Knowing that you may be at increased risk of having a stroke can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

To lower your risk of having a stroke, it is extremely important to live a healthy lifestyle. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about strokes online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

  • NHS: Here you can find more information about strokes and their symptoms and signs

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Strokes” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.