Up to half of childhood cancer survivors will develop hormone disorders

The guideline, titled "Hypothalamic-Pituitary and Growth Disorders in Survivors of Childhood Cancer: An Endocrine Society Clinical Practice Guideline," was published online and will appear in the July 2018 print issue of The Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society. Recent data shows that almost 50 percent of these survivors will develop an endocrine disorder over their lifetime. The guideline provides recommendations on how to diagnose and manage certain endocrine and growth disorders commonly found in childhood cancer survivors.

Childhood cancer is relatively rare, and due to improvements in treatment and patient care, the current five-year survival rates exceed 80 percent. It's estimated that by 2020, there will be half a million childhood cancer survivors in the United States. These survivors face a greater risk of developing serious medical complications, even decades after cancer treatment ends. Endocrine disorders are especially prevalent among this population, often as a result of their previous treatments, particularly exposure to radiation therapy.

"Childhood cancer survivors have a high risk of developing endocrine disorders," said Charles A. Sklar, M.D., of the Memorial Sloan Kettering Cancer Center in New York, N.Y. Sklar chaired the writing committee that developed the guideline. "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."

Recommendations from the guideline include long-term screening of childhood cancer survivors who underwent radiation therapy to the brain. This population should be screened for growth disorders, pituitary hormone deficiencies, and early puberty. If a condition is diagnosed, in most instances, clinicians should treat these survivors with the same approaches as other patients who develop endocrine conditions.

Other members of the Endocrine Society writing committee that developed this guideline include: Zoltan Antal of the New York Presbyterian Hospital, Weill Cornell Medical College and the Memorial Sloan Kettering Cancer Center in New York, N.Y.; Wassim Chemaitilly of St. Jude Children's Research Hospital in Memphis, Tenn.; Laurie E. Cohen of Boston Children's Hospital in Boston, Mass.; Cecilia Follin of Skane University Hospital in Lund, Sweden; Lillian R. Meacham of Emory University School of Medicine in Atlanta Ga.; and M. Hassad Murad of Mayo Clinic in Rochester, Minn.

The Society established the Clinical Practice Guideline Program to provide endocrinologists and other clinicians with evidence-based recommendations in the diagnosis, treatment, and management of endocrine-related conditions. Each guideline is created by a writing committee of topic-related experts in the field. Writing committees rely on evidence-based reviews of the literature in the development of guideline recommendations. The Endocrine Society does not solicit or accept corporate support for its guidelines. All Clinical Practice Guidelines are supported entirely by Society funds.

The Clinical Practice Guideline was co-sponsored by the European Society of Endocrinology and the Pediatric Endocrine Society. The Pituitary Society endorsed the guideline.