Endocrine Abstracts

By 2010 one in 250 of the adult population was a long-term survivor of childhood cancer (CC). In 2014 there were an estimated 420,000 CC survivors in the USA alone(Robison et al. 2014). In a follow-up study of 14,000 aging survivors of CC (Mostoufi-Moab et al 2016), in whom the median age at cancer diagnosis was 6 years and at the last Follow-up 32 years, 44% had a least one endocrinopathy,16.7% had at least 2 endocrinopathies and 6.6% had 3 or more endocrinopathies. The key documented modalities of treatment that induced these endocrinopathies are radiotherapy and certain forms of chemotherapy. Over the last 40+ years the following endocrine sequelae have been noted: Hypopituitarism, Thyroid dysfunction, Thyroid tumours, Hyperparathyroidism, Hypogonadism and Infertility, Osteoporosis, Insulin Resistance and Diabetes Mellitus. Newer treatments for certain malignancies such as Proton Beam Therapy for medulloblastoma (Yock et al. 2016), whilst achieving comparable survival figures to those seen after conventional radiotherapy, are still associated with significant endocrine deficits (63% at 7 years). In general, the Paediatric Endocrinologist is reasonably aware of the endocrine requirements, the efficacy of therapy, and the safety issues for CC survivors during childhood. However this is a relatively new field for the Adult Endocrinologist expected to look after these patients during adult life.