Chapter 13 - Endocrine Effects of Therapy

Abstract

Publisher Summary This chapter discusses primary end organ disturbances as well as the complexities of the orchestral conductor. The compilation of additional knowledge related to the late effects of cancer therapy can allow to perform precautionary and protective procedures prior to radiotherapy or chemotherapy. Testicular biopsy, including the calculation of the tubular fertility index (TFI), semen analysis, and endocrine assessment are employed to study the effects of cytotoxic drugs on the testis. Certain variables should be considered when analyzing the effects of radiation on the testis. Although it is not possible to routinely biopsy the ovaries, primary ovarian failure is relatively easy to diagnose by menopausal symptoms, vaginal and uterine atrophy, elevated levels of follicle stimulating hormone and luteinizing hormone, and a fall in serum estradiol. Thereafter, routine curative, external beam radiotherapy for carcinoma of cervix, and other pelvic cancer always causes irreversible, primary ovarian failure. The minimum radiation dose required to produce irreversible ovarian ablation is inversely related to a woman's age, and number of oocytes remaining. Interestingly, there is much confusion over the radiation tolerance of the nervous system. The likelihood of other end points/sequelae of central nervous system radiation following various dose, time, fraction size radiotherapy prescriptions can be predicated with a degree of accuracy.