Journal of Cancer Survivorship

, Volume 9, Issue 4, pp 630–640 | Cite as

Hormonal dysfunction is frequent in cancer survivors treated with radiotherapy to the head and neck region

  • Mette SelandEmail author
  • Trine Bjøro
  • Torbjørn Furre
  • Thomas Schreiner
  • Jens Bollerslev
  • Sophie Dorothea Fosså
  • Jon Håvard Loge
  • Harald Holte
  • Cecilie Essholt Kiserud



Cancer treatment may lead to hormonal dysfunction. Therefore, we assessed the prevalence of dysfunction in four hormonal axes among long-term cancer survivors who received radiotherapy to the head and neck region and analyzed associations between hormonal status and clinical variables.


We included 140 cancer survivors who received radiotherapy to the head and neck region, either locally or through total body irradiation after a diagnosis of lymphoma, plasmacytoma/multiple myeloma, or carcinoma of the epipharynx. Radiation doses to the pituitary gland and thyroid gland were estimated, and blood samples were collected to analyze hormonal levels.


At a median of 16 years after their cancer diagnosis, 46 % of cancer survivors showed dysfunction in one hormonal axis, 24 % had dysfunction in two axes, and 3 % had dysfunction in three axes. Twenty cancer survivors (14 %) had hormone levels consistent with pituitary dysfunction. Cancer survivors who had received an estimated 30 Gray (Gy) or more to the pituitary gland had an increased risk for pituitary dysfunction in one of the hormonal axes (odds ratio [OR] 3.16, confidence interval [CI] 1.02–9.87, p = 0.047) and for growth hormone dysfunction alone (OR 2.96, CI 1.02–8.55, p = 0.045).


Abnormal hormone values are frequent after radiotherapy to the head and neck region.

Implications for Cancer Survivors

Screening for hormonal dysfunction during follow-up might be indicated.


Hormonal dysfunction Radiotherapy Cancer Late effects 



We would like to thank the cancer survivors who participated in the survey. We would also like to thank Jan F. Evensen, Division of Surgery and Cancer Medicine, OUS, for help with provision of study patients; Are H. Pripp, Unit of Biostatistics and Epidemiology, OUS, for help with data analysis; Karsten Eilertsen, Department of Physics, Division of Surgery and Cancer Medicine, OUS, for help with the estimation of radiation doses; Olav I. Håskjold, Department of Radiology and Nuclear Medicine, OUS, for help with creating a template for the average position of the thyroid gland on X-ray images; and Kirsten A. Larsen, National Advisory Unit on Late Effects after Cancer Treatment, OUS, for practical assistance. This project has been financed with the aid of the Norwegian Cancer Society.

Ethical considerations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients included in this study.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Mette Seland
    • 1
    Email author
  • Trine Bjøro
    • 1
  • Torbjørn Furre
    • 1
  • Thomas Schreiner
    • 1
  • Jens Bollerslev
    • 1
  • Sophie Dorothea Fosså
    • 1
  • Jon Håvard Loge
    • 1
  • Harald Holte
    • 1
  • Cecilie Essholt Kiserud
    • 1
  1. 1.Oslo University HospitalOsloNorway

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