ENDOCRINE DISORDERS

Endocrine Society: Guidelines For Diagnosis of Endocrine Disorders in Childhood Cancer Survivors

July 3, 2018

The Endocrine Society has released a new clinical practice guideline on the diagnosis and treatment of hypothalamic-pituitary and growth disorders in survivors of childhood cancer.1

Due to treatment advances, the number of survivors of childhood cancer has significantly increased in recent years, and the guideline authors note that of these survivors, nearly half will develop and endocrine disorder.


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Risk factors for these endocrine disorders, they explained, can be both host- (age, sex, etc) and treatment-related, with radiation exposure to key endocrine organs listed as the greatest risk factor for developing an endocrine abnormality over time.

The guideline was based upon two systematic reviews evaluating the effects of growth hormone treatment in childhood cancer survivors on adult height, risk of type 2 diabetes, abnormal lipids, metabolic syndrome, quality of life, secondary tumors, and disease recurrence, as well as the best screening and diagnostic tests for growth hormone treatment in childhood cancer survivors exposed to hypothalamic-pituitary radiation.

"Our new guideline addresses the growing risk of endocrine disorders among childhood cancer survivors and suggests best practices for managing pituitary and growth disorders commonly found in this population. The guideline stresses the importance of life-long screening of these survivors for earlier detection and optimal patient care," said Charles A Sklar, MD, of the Memorial Sloan Kettering Cancer Center in New York, NY, who chaired the guideline writing committee.2

—Michael Potts

References:

  1. Sklar CA, Antal Z, Chemaitilly W, et al. Hypothalamic–pituitary and growth disorders in survivors of childhood cancer: an endocrine society clinical practice guideline [published online June 29, 2018]. JCEM. https://doi.org/10.1210/jc.2018-01175.
  2. Up to half of childhood cancer survivors will develop hormone disorders [press release]. June 29, 2018. https://www.eurekalert.org/pub_releases/2018-06/tes-uth062618.php.