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Endocrine late effects of cancer treatment


Authors: M. Kosák
Authors‘ workplace: Interní klinika 1. LF UK a ÚVN, Praha
Published in: Klin Onkol 2021; 34(6): 440-449
Category: Review
doi: https://doi.org/10.48095/ccko2021440

Overview

Background: Endocrine disorders are one of the common late complications of cancer treatment in childhood and adulthood. The incidence is more common in individuals who underwent oncology treatment in childhood in whom the estimated prevalence of these disorders is 20–50%. With improving treatment, there is an increasing number of people with a history of cancer treatment and thus persons who are potentially at risk of developing endocrine disorders. In adults, the prevalence of disorders is lower compared to those who had treatment in their childhood; however, endocrinological complications are relatively common even here, although the dia­gnosis is given less attention in adults compared to children. Endocrine disorders are possible complications of practically all treatment modalities used in oncology (radiotherapy, chemotherapy and immunotherapy). In terms of the type of disorders, these mainly include hypofunction or – more rarely – hyperfunction of the endocrine glands and secondary endocrine neoplasms, especially radiotherapy-induced thyroid tumors. The disadvantages of endocrine disorders are often non-specific and slowly developing symptoms. In addition to a clinical examination with an assessment of the presence of possible clinical manifestations, regular laboratory tests should also be performed to allow for early detection. The level of risk of developing endocrine disorders varies and depends on a number of factors, including the age at which the individual underwent treatment as well as the type of treatment: radiation dose, type of chemotherapy, etc. Based on these data, individualized monitoring plan for the individual needs should be made, allowing an early detection of these disorders. The advantage of endocrinological consequences is the fact that if properly and timely dia­gnosed, they are relatively easy to treat and the treatment often allows for full restitution of the condition. Purpose: The purpose of this article is to present a brief overview about broad spectrum of various possible endocrine complications of cancer treatment, how to dia­gnose and treat them, aiming to increase awareness about this topic among the health care professionals who treat these patients.

Keywords:

hypopituitarism – endocrine late effects – hypogonadism – secondary neoplasm


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