Cytotoxic Endocrinopathy: A Legacy of Insults

Abstract

Over the past 35 years, oncologists have vastly improved the survival figures for several malignant diseases, especially the common varieties seen in childhood. What is the quality of life in the many survivors? One aspect that has generated much attention is endocrine function.Radiation can directly impair hypothalamic, pituitary, thyroid, pancreatic and gonadal function as well as predisposing to development of hyperparathyroidism, and thyroid adenomas or carcinomas. Cytotoxic chemotherapy can damage the gonad, and both irradiation and cytotoxic chemotherapy may interfere with the normal growth of bone. These complications of treatment lead to clinical presentations including infertility, gynaecomastia, hypogonadism, impaired growth, failure to undergo normal pubertal development, precocious puberty, hyperparathyroidism, hypothyroidism, thyroid tumours, diabetes mellitus1 and varying degrees of hypopituitarism.

A Special Approach for Stereotactic Radiofrequency Thermocoagulation of Hypothalamic Hamartomas With Bilateral Attachments to the Hypothalamus: The Transthird Ventricular Approach to the Contralateral Attachment

“…Previous reports demonstrated that hypothalamic damage induced by radiation therapy, traumatic brain injury, or subarachnoid hemorrhage could cause deficiency of one or more anterior pituitary hormones. 27-30 Interestingly, most of these reports demonstrated that growth hormone was the most vulnerable, but this study showed that thyroid and corticosterone deficiencies were frequent. Although the difference in mechanisms was unclear, protection of at least one side of the hypothalamus is believed to be important for preserving hypothalamic regulation of pituitary function.…”

Pharmacokinetics, safety, and tolerability of Pentoxifylline intravaginal gel for subfertile/ infertile couples with low sperm quality: phase I randomized controlled clinical trial in healthy women

“…167 Chemotherapy treatment can induce azoospermia, which is permanent in most cases. 168 [Evidence level 3]…”

Male Infertility – A Review

“…103 Chemotherapy treamnet may lead to azoospermia, which, in most cases, is permanent. 104 Among recreational drugs, anabolic steroids and cocaine can have adverse effect on the semen quality. [105][106][107] Genetic and chromosomal alteration, after all, has its role to play in human azoospermia.…”