Endocrine late effects in childhood cancer survivors

Endocrine complications frequently occur as late effects of cancer treatments and have been reported to affect as many as 50% of childhood cancer survivors (CCS). CCS are also vulnerable to life-threatening chronic health conditions, such as cardiovascular disease, with known repercussions on quality of life and longevity. Radiotherapy and alkylating chemotherapy agents represent the highest treatment-related risk factors for endocrine late effects. The most frequently observed are: hypothalamic/pituitary dysfunction, primary thyroid disease, primary gonadal insufficiency, bone mineral density deficit, obesity, and diabetes mellitus. Implementing a systematic approach where CCS are periodically evaluated based on their cancer and treatment histories may allow more rapid diagnosis and treatment. This may prevent untreated endocrinopathies from further contributing to the morbidity and mortality risk of individuals within this vulnerable population.