Some of the functions of the PLAIN summaries work best on the desktop version. We are currently working on optimizing the mobile version.
Other PLAIN summaries
- Asymptomatic coronary artery disease
- Bone problems
- Cancer-related fatigue
- Central precocious puberty – CPP
- Chronic pain
- Craniofacial growth problems
- Dental and oral problems
- Dyslipidemia
- Eye problems
- Gastro-intestinal problems
- Hair loss
- Health promotion
- Hearing problems
- Heart problems
- Higher risk groups
- HP axis problems
- Hypertension
- Impaired glucose metabolism and diabetes
- Kidney problems
- Liver problems
- Lower urinary tract problems
- Lung problems
- Male fertility problems, testosterone deficiency and sexual dysfunction
- Mental health problems
- Neurocognitive problems
- Obstetric problems
- Overweight and obesity
- Peripheral neuropathy
- Premature ovarian insufficiency
- Psychosocial problems
- Spine scoliosis and kyphosis
- Spleen problems
- Stroke
- Subsequent neoplasms:
- Thyroid problems
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.
This PLAIN summary is based on the PanCareFollowUp guideline about “Strokes” [1], which is based on the consensus of different national guidelines.
PLAIN version 2.1: 27/05/2024
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.
Causes of a stroke
Created with BioRender.com
Hover over the letters/numbers in the figure for more information.
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all. See diagram[E1] .
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
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.
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all.
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
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
Symptoms and signs
Symptoms of a stroke
Created with BioRender.com
Hover over the numbers in the figure for more information.
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.
Healthy lifestyle
- Having a healthy diet
- Drinking less (or no) alcohol
- Exercising regularly
- Quitting smoking (if you smoke)
Your follow-up care specialist or general practitioner may give you additional advice tailored to your individual situation for maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.
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.