{"title":"Beyond Bone Mineral Density: The Impact of Childhood Cancer and Its Treatment on Bone Structure and Strength.","authors":"Melissa Fiscaletti, Nathalie Alos, Leanne M Ward","doi":"10.1159/000518501","DOIUrl":"https://doi.org/10.1159/000518501","url":null,"abstract":"<p><p>The spectrum of bone morbidity in childhood cancer survivors (CCS) is broad and extends beyond \"low bone mineral density\" to structural damage including fracture-induced vertebral deformity, and joint collapse due to osteonecrosis or slipped capital femoral epiphysis. In addition, short stature, scoliosis, leg length discrepancy, and vertebral deformity can arise from critical interference with growth plate activity. In some cases, insufficient residual growth potential or irreversible growth plate damage can lead to permanent structural deformity, leaving the patient with chronic functional limitations. In this chapter, we describe the clinical manifestations, natural history, and risk factors for cancer-related bone morbidity, approaches to monitoring and diagnosis, and the (paucity of) data available on prevention and treatment measures. In so doing, we unveil important biological principles about the potential for the pediatric skeleton to recover from bone morbidity, obviating the need for treatment, versus permanent structural damage that can negatively impact quality of life over the long-term. These observations, in turn, illuminate the unmet needs that drive future research to improve musculoskeletal strength and mobility in this setting.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"69-90"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicoletta Fortunati, Filippo Gatti, Francesco Felicetti, Enrico Brignardello
{"title":"Cancer Treatment-Induced Bone Loss in Hormone-Sensitive Cancer: The Paradigm of Cancer Survivor Bone Health Management.","authors":"Nicoletta Fortunati, Filippo Gatti, Francesco Felicetti, Enrico Brignardello","doi":"10.1159/000514692","DOIUrl":"https://doi.org/10.1159/000514692","url":null,"abstract":"<p><p>Cancer therapy-induced bone loss (CTIBL), occurring especially in hormone-treated breast and prostate cancer patients, is a noteworthy long-term consequence of cancer treatments. Because of its negative impact on the quality life of cancer survivors, it deserves much attention. We here summarize the pathophysiology of CTIBL in breast and prostate cancer, its clinical presentation, management, and treatment.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"91-102"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38948286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Enrico Brignardello, Francesco Felicetti, Hanneke M van Santen
{"title":"Preface.","authors":"Enrico Brignardello, Francesco Felicetti, Hanneke M van Santen","doi":"10.1159/000519426","DOIUrl":"https://doi.org/10.1159/000519426","url":null,"abstract":"","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"VII-VIII"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39465643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiska van Schaik, Eelco W Hoving, Hermann L Müller, Hanneke M van Santen
{"title":"Hypothalamic-Pituitary Outcome after Treatment for Childhood Craniopharyngioma.","authors":"Jiska van Schaik, Eelco W Hoving, Hermann L Müller, Hanneke M van Santen","doi":"10.1159/000515318","DOIUrl":"https://doi.org/10.1159/000515318","url":null,"abstract":"<p><p>Although childhood-onset craniopharyngioma is a low-grade intracranial tumor with excellent prognosis in terms of overall survival, survivors may suffer from devastating consequences caused by hypothalamic damage. Disease- or treatment-related hypothalamic damage leads to disturbed hunger-satiety and thirst feelings, decreased energy expenditure, behavioral problems, disturbances of circadian rhythm, temperature dysregulation, and pituitary dysfunction. These children are at great risk for developing the metabolic syndrome and comorbidities leading to premature mortality. In this chapter, we shall discuss hypothalamic-pituitary morbidity and outcome of childhood-onset craniopharyngioma patients and future perspectives for improvement.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"47-57"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38963401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca J van Kalsbeek, Renée L Mulder, Roderick Skinner, Leontien C M Kremer
{"title":"The Concept of Cancer Survivorship and Models for Long-Term Follow-Up.","authors":"Rebecca J van Kalsbeek, Renée L Mulder, Roderick Skinner, Leontien C M Kremer","doi":"10.1159/000514693","DOIUrl":"https://doi.org/10.1159/000514693","url":null,"abstract":"<p><p>With improved survival of childhood, adolescent, and young adult (CAYA) cancer, the European survivor population of 300,000-500,000 continues to expand. Most survivors will experience at least one and often multiple cancer- and treatment-related late effects throughout their lives, including endocrine toxicities. Besides affecting their physical and psychosocial health status, these might reduce life expectancy and quality of life. Prevalent endocrine complications include hypothalamic-pituitary dysfunction, central precocious puberty, primary thyroid, male or female gonadal dysfunction, metabolic syndrome, and low bone mineral density. Long-term follow-up (LTFU) care, including education, risk-based prevention, and surveillance strategies, is essential to reduce the burden of endocrine complications and to allow for timely interventions. To integrate scientific expert knowledge, evidence-based clinical practice guidelines have been developed by the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) and PanCare. These guide LTFU care by describing risk populations and preferred surveillance modalities. Moreover, consensus-based recommendations have been developed by PanCareFollowUp where evidence-based guidance is still awaited. The PanCareSurFup models of care guidelines recommend multidisciplinary team care at or under guidance of a cancer survivorship expert center, so CAYA cancer survivors receive appropriate care and support to optimize health.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38905848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypothalamic-Pituitary Dysfunctions Other Than Growth Hormone Deficiency in Cancer Survivors.","authors":"Laura van Iersel, Wassim Chemaitilly","doi":"10.1159/000513806","DOIUrl":"https://doi.org/10.1159/000513806","url":null,"abstract":"<p><p>Hypothalamic-pituitary (HP) dysfunctions are commonly reported complications in survivors of childhood cancer. These include growth hormone deficiency, luteinizing hormone/follicle-stimulating hormone deficiency, thyroid-stimulating hormone deficiency, adrenocorticotropic hormone deficiency, central precocious puberty, hyperprolactinemia, and central diabetes insipidus. Local tumor invasion and surgical or radiation-induced injury represent the highest risk factors. New treatment modalities, such as immunotherapy and molecular targeted therapy have the potential to cause autoimmune hypophysitis. Untreated HP dysfunctions are associated with adverse physical and psychosocial consequences and reduced quality of life. Systematic and periodic endocrine assessments optimize early diagnosis and timely treatment and may improve long-term health outcomes.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"36-46"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25345851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maja Vestmø Maraldo, Alessandro Andreis, Ilenia Iamundo de Cumis, Marzia Cerrato, Angelisa Vella, Umberto Ricardi, Mario Levis
{"title":"Cardiometabolic Risk, Part 1: Chemotherapy and Radiotherapy - Old Foes Still Threatening Cancer Survivors?","authors":"Maja Vestmø Maraldo, Alessandro Andreis, Ilenia Iamundo de Cumis, Marzia Cerrato, Angelisa Vella, Umberto Ricardi, Mario Levis","doi":"10.1159/000513921","DOIUrl":"https://doi.org/10.1159/000513921","url":null,"abstract":"<p><p>Long-term cancer survivors are at high risk of developing cardiac complications from the treatments, both systemic agents and thoracic irradiation, received to cure the primary tumor. Modern advances, particularly in the field of radiotherapy, aim to reduce the risk of cardiovascular disease. Also, new diagnostic tools increasingly improve their efficacy in early detection of the preclinical treatment-induced cardiac damage. In this review, we summarize the mechanisms of radiotherapy- and chemotherapy-induced cardiac injury, the available clinical data, the strategies to mitigate cardiac exposure with modern radiotherapy and the current diagnostic tools for an early detection and prompt management of these complications in long-term cancer survivors.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"115-129"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25345235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marco Zavattaro, Fabio Lanfranco, Francesca Salvagno, Giovanna Motta, Marta Sestero, Lorenzo Marinelli, Stefano Canosa, Alberto Revelli
{"title":"Gonadal Failure and Infertility in Cancer Survivors: Clinical Management and Strategies for Prevention.","authors":"Marco Zavattaro, Fabio Lanfranco, Francesca Salvagno, Giovanna Motta, Marta Sestero, Lorenzo Marinelli, Stefano Canosa, Alberto Revelli","doi":"10.1159/000515460","DOIUrl":"https://doi.org/10.1159/000515460","url":null,"abstract":"<p><p>Modern advances in oncological treatments determined a significant improvement in survival rates for several malignancies. Nevertheless, survivorship and quality of life of cancer survivors may be negatively impaired by metabolic and endocrine side effects related to anticancer treatments, including alterations of pituitary-gonadal axis function. In fact, both medical (chemo- and radiotherapy) and surgical approaches may negatively impact on gonadal function, leading to transient or permanent hypogonadism and infertility. In view of these considerations, fertility preservation (FP) should be a primary concern in all oncological patients who may potentially achieve parenthood, irrespectively from their sex and pubertal status at treatment, and adequate counselling should be provided before undergoing gonadotoxic therapy or gonadectomy. Cryopreservation of gametes, when feasible, represents the mainstay for FP in postpubertal age, while procedures involving storage of tissue specimens or stem cells should still be considered as experimental. Given the complexity of both hormonal and psychological implications in this clinical setting, a multidisciplinary approach is advisable for optimal FP and for early diagnosis and treatment of hypogonadism.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"58-68"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38876420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Growth Hormone Deficiency and Growth Hormone Replacement in Childhood Cancer Survivors.","authors":"Briana C Patterson, Lillian R Meacham","doi":"10.1159/000515111","DOIUrl":"https://doi.org/10.1159/000515111","url":null,"abstract":"<p><p>Growth hormone deficiency (GHD) is common in childhood cancer survivors (CCS). Major risk factors for GHD include radiation therapy, both cranial and total body irradiation, and tumor location. Some newer anti-cancer therapies may impact growth and the GH-IGF-1 axis as well. While untreated childhood-onset GHD adversely impacts adult height in CCS, longstanding GHD can cause or exacerbate multiple metabolic and skeletal health problems. This chapter discusses considerations in the diagnosis and treatment of GHD in CCS and discusses long-term outcomes in survivors of childhood cancer who have GHD.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"25-35"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38938542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Accelerated Aging as a Paradigm to Understand the Late Effects of Cancer Therapies.","authors":"Saskia Martine Francesca Pluijm","doi":"10.1159/000518816","DOIUrl":"https://doi.org/10.1159/000518816","url":null,"abstract":"<p><p>Long-term childhood adolescent and young adult (CAYA) cancer survivors may develop health conditions that often coexist at young adulthood or middle age and that normally occur in persons aged 65 years and older, including cardiovascular and musculoskeletal diseases, metabolic syndrome, and secondary malignancies, suggesting that a process of accelerated aging occurs. This chapter summarizes epidemiological evidence and physiological mechanisms of accelerated aging, and possible preventive measures to delay the process of accelerated aging in CAYA cancer survivors. Evidence is mounting that in addition to a high prevalence of specific and multiple aging-related chronic diseases (multimorbidity), CAYA cancer survivors seem to also have a higher risk of other aging phenotypes, including frailty, poor physical performance, and changes in body composition (low muscle and high fat mass). Risk factors for these aging phenotypes include treatment-related factors (cranial-spinal radiotherapy, anthracyclines), sociodemographic factors (higher age, female sex, low socioeconomic status), and unhealthy lifestyle factors (i.e., physical inactivity, obesity, smoking, excess alcohol consumption). The process of accelerated aging may be prevented or delayed by adopting and maintaining a healthy lifestyle, so that CAYA cancer survivors may live a life with optimal quality of life after cancer.</p>","PeriodicalId":50428,"journal":{"name":"Frontiers of Hormone Research","volume":"54 ","pages":"16-24"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39455356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}