Login
SurvivorLink™
Cancer SurvivorLink
Your Link to Care After Cancer
Skip Navigation LinksSurvivorLink > Providers > QuickFacts > Endocrine
Endocrine QuickFact

Childhood cancer survivors can be at risk for developing the following endocrine late effects:

  • Growth Hormone Deficiency
  • Hypothyroidism
    • Central
    • Primary
  • Hyperthyroidism
  • Thyroid Nodules
  • Adrenal Insufficiency
  • Hyperprolactinemia
  • Decreased Bone Mineral Density
  • Diabetes Insipidus
  • Diabetes Mellitus

See Ovary/Testis Quick Fact for the following late effects: 

  • Precocious Puberty
  • Gonadal Failure
  • Infertility

If your patient does not have a Survivor Healthcare Plan (SHP), please refer him/her to the appropriate survivor clinic.

Important factors in determining risk for endocrine late effects:

  • Age of patient at time of treatment
  • Total dose of radiation
  • Surgery or tumor in hypothalmic area
  • Time since treatment
  • Gender
  • Ethnicity
  • Body Mass Index
  • Smoking

 


Chemotherapy
Table 1
 

Growth Hormone Deficiency

Hypo-thyroidism

Hyper-thyroidism

Thyroid Nodules

Adrenal Insufficiency

Hyper-prolactinemia

Decreased bone mineral density

Diabetes Insipidus

Diabetes Mellitus

Alkylating Agents
BCNU
Busulfan
CCNU
Chlorambucil Cyclophosphamide
   Cytoxan
Ifosphamide
Mechlorethamine
Melphalan
Procarbazine
Thiotepa
 
Dacarbazine
    DTIC
Temozolomide

 

 

 

 

 

 

 

 

 

Heavy Metals
Carboplatin
Cisplatin
 

 

 

 

 

 

 

 

 

 

Antimetabolites
Cytarabine
   Ara-C
Mercaptopurine
   6MP
Thioguanine
   6TG
Methotrexate
 

 

 

 

 

 

 

 
X

 

 

Anthracycline antibiotics
Daunorubicin
Doxorubicin
   Adriamycin
Epirubicin
Idarubicin
Mitoxantrone
 

 

 

 

 

 

 

 

 

 

Chemotherapy
Table 2
 

Growth Hormone Deficiency

Hypo-thyroidism

Hyper-thyroidism

Thyroid Nodules

Adrenal Insufficiency

Hyper-prolactinemia

Decreased bone mineral density

Diabetes Insipidus

Diabetes Mellitus

Anti-tumor antibiotics
Bleomycin
Dactinomycin
 

 

 

 

 

 

 

 

 

 

Corticosteroids
Dexamethasone
   Decadron
Prednisone
 

 

 

 

 

 

 

 
X

 

 

Enzymes
Asparaginase
 

 

 

 

 

 

 

 

 

 

Plant alkaloids
Vincristine
Vinblastine
 

 

 

 

 

 

 

 

 

 

Epipodophyllotoxins
Etoposide
   VP16
Teniposide
   VM26
 
 

 

 

 

 

 

 

 

 

 

Radiation

Growth Hormone Deficiency

Hypo-thyroidism

Hyper-thyroidism

Thyroid Nodules

Adrenal Insufficiency

Hyper-prolactinemia

Decreased bone mineral density

Diabetes Insipidus

Diabetes Mellitus

All Radiation     

 

 

 

 

 

 

 

 

 

TBI

X

X

 

X

 

 

 
 

 

 

Head/Brain

X

> 40 Gy 
  
Include TBI in total dose calculation

 

X

> 30 Gy 
  
Include TBI in total dose calculation

> 40 Gy 
  
Include TBI in total dose calculation

 

 

 

Neck

 

X

X

X

 

 

 

 

 

Thorax

 

X

X

X

 

 

 

 

 

Abdomen

 

 

 

 

 

 

 

 

X

Pelvis

 

 

 

 

 

 

 

 

 

Extremity
 

 

 

 

 

 

 

 
 

 

 

Surgery/Other

Growth Hormone Deficiency

Hypo-thyroidism

Hyper-thyroidism

Thyroid Nodules

Adrenal Insufficiency

Hyper-prolactinemia

Decreased bone mineral density

Diabetes Insipidus

Diabetes Mellitus

Thyroidectomy

 

X

 

 

 

 

 

 

 

Neurosurgery - Brain

 

 

 

 

 

 

 

X

 

Radioiodine Therapy

 

X

 

 

 

 

 

 

 

Systemic MIBG in therapeutic doses

 

X

 

 

 

 

 

 

 

Hematopoietic
Stem Cell Transplant

Growth Hormone Deficiency

Hypo-thyroidism

Hyper-thyroidism

Thyroid Nodules

Adrenal Insufficiency

Hyper-prolactinemia

Decreased bone mineral density

Diabetes Insipidus

Diabetes Mellitus

Hematopoietic
Stem Cell Transplant

 

 

 

 

 

 

X

 

 

Hematopoietic Stem Cell Transplant with ANY history of chronic Graft vs. Host Disease (GVHD)

 

 

 

 

 

 

 

 

 

For recommendations on how to screen for all potential late effects, please refer to The Children’s Oncology Group Long-term Follow-up Guidelines.

Health Links- Teaching Handouts from The Children's Oncology Group  

Visit www.survivorshipguidelines.org  to find many of the Health Links translated into other languages. 

References:

Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, and related Health Links Version 4.0. October, 2013. www.survivorshipguidelines.org.

Source: Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta
Last Updated: 2/2/2015 7:02:35 PM
SurvivorLink™ has been designed to increase awareness and knowledge about the life-long healthcare needs of pediatric cancer survivors, and increase communication about the specific healthcare needs of individual survivors between survivor and family, cancer survivor team, primary care provider, and healthcare subspecialists.
© 2009-2017 Emory University