Long-Term Endocrine Sequalae of Cancer Therapy

There are an increasing number of patients living with and beyond cancer (LWBC) who are susceptible to both short- and long-term cancer therapy related side effects. Long-term endocrine sequelae of cancer therapies occur in up to 50% of childhood cancer survivors and may occur decades after the treatment has been delivered. These consequences of treatment can cause significant morbidity and increased mortality if not diagnosed and appropriately managed. This chapter will provide an overview of these endocrine sequalae include disturbances of growth and puberty, hypothalamo-pituitary (HP) dysfunction, hypogonadism, thyroid dysfunction, benign and malignant thyroid nodules, hyperparathyroidism, and bone effects. The relative contributions of cancer treatment modalities such as radiotherapy and chemotherapy and patient factors are discussed. Appropriate screening, diagnostic testing, and treatment algorithms are also described.