Endocrine Complications in Childhood Cancer Survivors

Abstract

Endocrine complications are among the commonly observed complications in childhood cancer survivors, affecting between 20 and 50 % of individuals who survive into adulthood. Most endocrine complications are the result of prior cancer treatments, especially radiotherapy, and often manifesting several years, sometimes decades after exposure. Such treatments can cause direct damage to the hypothalamic–pituitary axis, thyroid gland, and gonads, induce osteopenia and osteoporosis, and alter body composition and glucose homeostasis. The integrity of endocrine function is important for the maintenance of an individual’s physical and psychosocial well-being. Given the high rates of frailty and decreased quality of life in childhood cancer survivors, long-term endocrine screening, treatment, and follow-up need to become a priority for clinicians and investigators with expertise in this field. The aim of the present review is to highlight the main endocrine complications, including disorders of the hypothalamic–pituitary axis, thyroid dysfunction, gonadal dysfunction, decreased bone mineral density, obesity, and disorders in glucose homeostasis, and to provide recommendations for screening for late endocrine complications observed in this vulnerable population.