DIAGNOSIS OF ENDOCRINE DISEASE: Endocrine late-effects of childhood cancer and its treatments

Chemaitilly, Wassim; Cohen, Laurie E.

doi:10.1530/eje-17-0054

Cited by 69 publications

(61 citation statements)

References 199 publications

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“…This is in keeping with previously published data, demonstrating that endocrine late effects constitute one of the most frequent sequelae [23,24]. Almost every fifth female childhood cancer survivor was affected by hypothyroidism, which renders the disorder significantly more common in our study group than in age-adjusted controls from general population [25].…”

Section: Discussionsupporting

confidence: 93%

Multidisciplinary Late Effects Clinics for Childhood Cancer Survivors in Germany - a Two-Center Study

et al. 2018

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Background: Childhood cancer survivors are at risk for therapy-related sequelae and, therefore, require long-term follow-up. At 2 university hospitals in Germany collaborative multidisciplinary late effects clinics were installed to provide specialized care and to evaluate the current health status of these patients in a clinical setting. Patients andMethods: Every patient who visited the late effects clinics at the university hospital in Lübeck and Erlangen over a period of 3 years and met the inclusion criteria was included in the study. Patients' characteristics as well as cancer diagnosis, treatment related factors and the prevalence of chronic health conditions were assessed. Results: 220 patients attended the late effects clinics during the observation period. The median follow-up period was 16 years (range 5-45 years). In total over 64% of the patients were affected by at least 1 chronic health condition, including endocrine disruptions in 19.1% of the patients. Moreover, secondary neoplasms occurred in 9.1% of the study participants. Conclusion: German childhood cancer survivors are affected by multiple therapy-related sequelae. A comprehensive network of late effects clinics should be established to ensure specialized and risk-adapted care for every childhood cancer survivor in Germany.

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Section: Discussionsupporting

confidence: 93%

Multidisciplinary Late Effects Clinics for Childhood Cancer Survivors in Germany - a Two-Center Study

et al. 2018

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“…Although primary hypothyroidism in childhood cancer survivors is a well-known effect [83] the prevalence of SH compared with overt hypothyroidism is not yet well defined.…”

Section: Mild Hypothyroidism In Childrenmentioning

confidence: 99%

Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated?

Vigone

Capalbo

Weber

et al. 2018

Journal of the Endocrine Society

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Mild hypothyroidism, also known as subclinical hypothyroidism (SH), is biochemically defined as serum TSH levels above the upper limit of the reference range, in the presence of normal serum concentrations of total T4 and free T4 (FT4). In the neonatal period, mild hypothyroidism can be defined by the presence of a TSH value between 6 and 20 mIU/L and normal FT4 levels. After the neonatal period, SH can be defined mild if TSH ranges between 4.5 and 10 mIU/L. The management of mild hypothyroidism in childhood is challenging. The major concern is to establish whether this condition should always be considered an expression of mild thyroid dysfunction. Indeed, the effects of untreated mild hypothyroidism are still not completely defined. In the neonatal period, concern exists about neurocognitive outcome; in children, although there is no clear evidence of alterations in growth or neurocognitive development, subtle cardiovascular abnormalities have been documented. Therefore, there is still uncertainty about the need of treatment across all ages, and the management should be based on the age of the child, the etiology, and the degree of TSH elevation, as well as on other patient factors. This review updates current evidences on diagnosis and management of mild hypothyroidism in childhood.

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“…Similar findings have been reported among survivors of adult‐onset cancer who wanted (additional) children after treatment, and the cancer experience may also alter whether survivors desire to have children . Although adult survivors of childhood cancer may experience comparable difficulties as they are frequently faced with fertility problems (eg, reduced sperm count/ovarian reserve) or infertility/sterility in adulthood, little research has focused on this unique and diverse population.…”

Section: Introductionmentioning

confidence: 99%

“…Their uniqueness stems from circumstances at the time of diagnosis and treatment. In pediatric oncology, developmental stages and maturity of patients vary greatly, as does risk for infertility . Additionally, fertility preservation options vary by a child's age and sex, and remain experimental for young children .…”

Section: Introductionmentioning

confidence: 99%

The perceived impact of infertility on romantic relationships and singlehood among adult survivors of childhood cancer

et al. 2019

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Objective To examine whether adult survivors of childhood cancer perceive a direct impact of potential/confirmed infertility on their romantic relationships/singlehood. Methods Open‐ended qualitative phone interviews were conducted with 57 adult survivors of childhood cancer and analyzed through thematic content analysis until saturation was reached (N = 30). Results Interviews revealed three major themes: (1) impact on survivors, (2) impact on partners/romantic relationships, and (3) alternative routes to parenthood. An overarching theme related to (4) timing also emerged. In describing the impact on themselves, survivors shared subthemes of (1.1) becoming aware of infertility as potential late effect of childhood cancer treatment and (1.2) their emotional reactions (ie, worries/concerns, distress, guilt, no emotional reaction). The impact on partners/romantic relationships also included subthemes: (2.1) partner communication, (2.2) partner reactions, and (2.3) the journey of active family planning. Conclusions The perceived impact of potential/confirmed infertility on romantic relationships of adult survivors of childhood cancer varied across individuals and time. Its presence or absence depends on life circumstances (eg, marital status, life goals), and if present, negative effects were typically resolved over time by having a pregnancy. Other survivors found joy and comfort in step‐children, considering adoption, or embracing a life without children. While more research is needed, findings indicate that discussions about infertility and fertility testing should be tailored to individual survivors and their needs, which may change over time. Timely referrals to reproductive specialists or adoption agencies are recommended for those who want children and have difficulties conceiving.

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DIAGNOSIS OF ENDOCRINE DISEASE: Endocrine late-effects of childhood cancer and its treatments

Cited by 69 publications

References 199 publications

Multidisciplinary Late Effects Clinics for Childhood Cancer Survivors in Germany - a Two-Center Study

Multidisciplinary Late Effects Clinics for Childhood Cancer Survivors in Germany - a Two-Center Study

Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated?

The perceived impact of infertility on romantic relationships and singlehood among adult survivors of childhood cancer

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