Late Endocrine Sequelae Following Treatment Of Childhood Cancer

With an ever increasing adult population of childhood cancer survivors there is a need to focus on the late effects of cancer therapy. Endocrine and metabolic consequences may affect a patient’s life both soon after cancer treatment and also for many years in the future. We have considered the effects of growth hormone deficiency and the benefits of replacement in adulthood particularly in the area of QoL. Osteopaenia is observed, although there are no long-term fracture data. Therapeutic measures to increase BMD ± and consequently reduce fractures ± should be assessed, including adequate sex hormone replacement to achieve peak bone mass. Thyroid problems are common and should be under annual surveillance. It is therefore essential that the impact of dieting modalities and doses on the incidence of late effects is kept under review. After discharge from the pediatric oncologists the patients should not be lost from the health system but should remain under continued surveillance with access to appropriate physicians. The benefits of hormone replacement and other therapeutic measures should be studied in order to minimize the impact on the patient’s health and QoL.