Looking for Late Endocrine Complications in Childhood Cancer Survivors

More than half of childhood cancer survivors develop endocrine and metabolic complications long after their treatment is complete and their cancer is cured. As a result, researchers are following survivor cohorts more closely and for longer durations than ever before.

Wassim Chemaitilly, MD, and Melissa M. Hudson, MD, from St. Jude Children’s Research Hospital in Memphis recently assembled a review specifically focusing on endocrine and metabolic complications in childhood cancer survivors. Though they report that gonadal dysfunction, primary hypothyroidism, and growth hormone (GH) deficiency are identified most often, they discuss other conditions, as well.

The article’s strengths include a comprehensive review of existing literature; identification of endocrine and metabolic therapy-related late effects with consideration to the patient’s previous cancer and treatment; and suggestions for specific types of routine screening.

While childhood cancer survivors often see endocrinologists for short stature, the authors note that treatment for this condition can only occur after physicians work with patients to assess and discuss the risks that may affect cardiac health and quality of life (QOL). The researchers also discuss the effects of specific chemotherapies, and the conditions most likely to appear in later years.

This review emphasizes an area that is often overlooked: following childhood cancer survivors over the long term. Community-based physicians need to be more aware of these patients in their practices and actively look for the known complications of cancer and its treatment.