European Journal of Endocrinology www.eje-online.org © 2017 European Society of Endocrinology Printed in Great Britain Published by Bioscientifica Ltd. DOI: 10.1530/EJE-17-0054 DIAGNOSIS OF ENDOCRINE DISEASE Endocrine late-effects of childhood cancer and its treatments Wassim Chemaitilly 1,2 and Laurie E Cohen 3,4 Departments of 1 Pediatric Medicine-Division of Endocrinology and 2 Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, Tennessee, USA, 3 Division of Endocrinology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA and 4 Dana-Farber-Boston Children’s Hospital Center for Cancer and Blood Disorders, Cancer Survivorship Program, Boston, Massachusetts, USA Abstract Endocrine complications are frequently observed in childhood cancer survivors (CCS). One of two CCS will experience at least one endocrine complication during the course of his/her lifespan, most commonly as a late-effect of cancer treatments, especially radiotherapy and alkylating agent chemotherapy. Endocrine late-effects include impairments of the hypothalamus/pituitary, thyroid and gonads, as well as decreased bone mineral density and metabolic derangements leading to obesity and/or diabetes mellitus. A systematic approach where CCS are screened for endocrine late-effects based on their cancer history and treatment exposures may improve health outcomes by allowing the early diagnosis and treatment of these complications. Correspondence should be addressed to W Chemaitilly Email wassim.chemaitilly@stjude. org European Journal of Endocrinology (2017) 176, R183–R203 www.eje-online.org © 2017 European Society of Endocrinology 176:4 R183–R203 W Chemaitilly and L E Cohen Endocrine late-effects of childhood cancer Review Invited Author’s Profile Dr Wassim Chemaitilly currently serves as the Director of the Endocrinology Division at St Jude Children’s Research Hospital in Memphis, Tennessee, USA and has a joint faculty appointment with the institution’s Department of Epidemiology and Cancer Control where he conducts most of his clinical research. He is a pediatric endocrinologist with established interest in the long-term adverse effects of cancer and brain tumor treatments on the endocrine system. Dr Chemaitilly obtained his Medical Doctorate degree and Pediatric Medicine diploma at the Université René Descartes – Necker Enfants Malades in Paris, France before completing a Pediatric Endocrinology fellowship at New York Presbyterian Hospital, Weill Cornell Medical College in New York City in 2006. Introduction Childhood cancer cure rates have substantially improved over the past fve decades, resulting in a growing number of long-term survivors. In the USA, it is estimated that one out of 530 adults in their second or third decade of life is a childhood cancer survivor (CCS) (1). Progress in this feld is owed to treatments incorporating chemotherapy and/or radiotherapy in conjunction with supportive care to address acute complications. Surviving patients may go on to experience late-onset chronic health conditions months to decades after the primary cancer; such conditions are described as late-effects (2). Endocrine complications are among the most common late-effects in CCS and they frequently occur because of exposures to radiotherapy and/or alkylating agent chemotherapy. It is estimated that 50% of CCS will experience at least one endocrine or reproductive complication during the Downloaded from Bioscientifica.com at 06/06/2020 07:41:42PM via Massachusetts Inst of Technology