Health Link

Healthy living after treatment of childhood, adolescent, and young adult cancer

Late Effects after Amputation
Treatment for a childhood bone or soft tissue tumor of the arms or legs may include an amputation (removal of a limb orpart of a limb).
What are the potential late effects of amputation?
•Skin blisters, redness, or bruising from a poorly fitting prosthesis•

Phantom limb pain (perception of pain coming from the area where the limb used to be)•Shooting pains, severe cramping, or a burning sensation in the amputated limb•Skin breakdown and slow wound healing of the remaining limb•

Back or other muscle pain (due to increased use of other muscle groups and limbs to make up for decreased
function in the amputated extremity)•

Emotional distress related to change in body image•

Physical fitness limitations that may result in difficulties performing daily activities and maintaining a healthy
weightWhat are the follow-up recommendations for amputees?
•

Keep the residual limb clean and dry•

Check the skin daily for color changes and skin break down•

Regularly wash items that are used in the prosthesis (stump shrinker, elastic garments, stump socks)•

Have an evaluation of the prosthesis fit every 6 months until you are fully grown, then once a year, and if any
problems arise•Work with a physical and occupational therapist to develop a plan for gait training, activities of daily living, and an
exercise plan (including range of motion, strength, agility, and balance)•

Have a yearly physical examination•

Maintain a healthy diet and activity level

What are the signs that your prosthesis needs the attention of a prosthetist?
•

You hear noises of any kind (squeaking, popping, clicking, etc.)•You break any part of the prosthesis•You need new supplies•

You have outgrown the prosthesis•

You have chronic pain while wearing your prosthesis

What other issues occur after amputation?
•

Dealing with peer pressure and body image change•

Coping with “being different”•

Feeling anxious, unsure, or sad•Paying for a new prosthesis

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Health Link

Healthy living after treatment of childhood, adolescent, and young adult cancer•

Coping with environments that may or may not be accessible•

Using public transportation (airplane, train, bus, etc.)•In some cases, living with chronic pain (see related Health Link: Chronic Pain after Childhood Cancer)

Where can I get help?
Talk with your healthcare provider regularly to let them know of any difficulties that you may be facing. In addition, thefollowing web sites offer resources for amputees:•www.amputee-coalition.org
Provides resources for education, advocacy and peer support for amputees.

•www.amputee-coalition.org/limb-loss-resource-center/publications/
Provides information about “First Step, A Guide for Adjusting to Limb Loss” published by the Amputee Coalition ofAmerica.

Written by Victoria G. Marchese, PhD, PT, University of Maryland/Greenebaum Cancer Center, Baltimore, MD; Rajaram Nagarajan,
MD, MPH, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and Thomas R. Baker, CP (certified prosthetist), Wolfchase
Limb and Brace, Jackson, TN.
Reviewed by Leeann Carmichael DNP, APN, FNP-BC; Kayla L. Foster, MD, MPH; and Melissa Acquazzino MD, MS.
Reference: Lusardi MM, Jorge M, Orthotics & Prosthetics in Rehabilitation (3rd Ed). St. Louis: Saunders (an imprint of ElsevierInc.), 2013.

Additional health information for childhood cancer survivors is available atwww.survivorshipguidelines.org
Note: Throughout this Health Links series, the term “childhood cancer” is used to designate pediatric cancers that may occur during childhood, adolescence, or young adulthood.
Health Links are designed to provide health information for survivors of pediatric cancer, regardless of whether the cancer occurred during childhood, adolescence, or young
adulthood.
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Introduction to Late Effects Guidelines and Health Links: The Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers and accompanying Health
Links were developed by the Children’s Oncology Group as a collaborative effort of the Late Effects Committee and Nursing Discipline and are maintained and updated by the Children’s
Oncology Group’s Long-Term Follow-Up Guidelines Core Committee and its associated Task Forces.
To cancer patients (if children, their parents or legal guardians): Please seek the advice of a physician or other qualified health provider with any questions you may have regarding a
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