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Transition Considerations for Cancer Survivors with Endocrine Sequela

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Transitioning from Pediatric to Adult Care in Endocrinology

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Abstract

Childhood cancer survivorship is increasing. Now with more than 84% diagnosed with a childhood cancer surviving past 5 years from diagnosis, the population of childhood cancer survivors is growing to at least 1 in 750 American adults. With increasing numbers of survivors, comorbidities, especially endocrine effects of cancer treatment, are becoming quite common but heterogeneous depending on the therapies received. Adolescent and young adult cancer survivors require specialized care including continued screening and treatment of endocrine deficiencies long into adulthood and special management of endocrine issues such as bone disease, infertility, and lifelong risk of obesity and metabolic disease. Follow-up care is challenging during the transition process with barriers that include lack of knowledge by both healthcare providers and survivors of potential endocrine effects of therapy, pediatric providers being uncomfortable with adult issues, lack of access to adult healthcare specialists or multidisciplinary care centers, neuropsychological effects of childhood cancer and its treatments, and inefficiencies with transition of health information to adult providers. This chapter summarizes endocrine risks and sequelae of childhood cancer and transition approaches to optimize care for adolescents and young adult survivors with endocrinopathies or at risk for endocrinopathies secondary to childhood cancer.

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References

  1. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin K, editors. SEER Cancer statistics review, 1975–2014. Bethesda: National Cancer Institute; 2014. https://seer.cancer.gov/csr/1975_2014/, based on November 2016 SEER data submission, posted to the SEER web site.

    Google Scholar 

  2. Robison LL, Hudson MM. Survivors of childhood and adolescent cancer: life-long risks and responsibilities. Nat Rev Cancer. 2013;14:61–70.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Gurney JG, Kadan-Lottick NS, Packer RJ, et al. Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors: childhood cancer survivor study. Cancer. 2003;97:663–73.

    Article  PubMed  Google Scholar 

  4. Brignardello E, Felicetti F, Castiglione A, Chiabotto P, Corrias A, Fagioli F, Ciccone G, Boccuzzi G. Endocrine health conditions in adult survivors of childhood cancer: the need for specialized adult-focused follow-up clinics. Eur J Endocrinol. 2013;168:465–72.

    Article  CAS  PubMed  Google Scholar 

  5. Chemaitilly W, Li Z, Huang S, et al. Anterior hypopituitarism in adult survivors of childhood cancers treated with cranial radiotherapy: a report from the st jude lifetime cohort study. J Clin Oncol. 2015;33:492–500.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Children’s Oncology Group. Long-term Follow-up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. Version 4.0. Arcadia, CA: Children’s Oncology Group; 2013. p. 1–241.

    Google Scholar 

  7. Oeffinger KC, Hudson MM. Long-term complications following childhood and adolescent cancer: foundations for providing risk-based health care for survivors. CA Cancer J Clin. 2004;54:208–36.

    Article  PubMed  Google Scholar 

  8. Müller HL. Consequences of craniopharyngioma surgery in children. J Clin Endocrinol Metab. 2011;96:1981–91.

    Article  PubMed  Google Scholar 

  9. Hameed R, Zacharin MR. Long-term endocrine effects of cancer treatment: experience of the Royal Children’s Hospital, Melbourne. J Paediatr Child Health. 2005;41:36–42.

    Article  CAS  PubMed  Google Scholar 

  10. Pardo JV, Sheikh SA, Kuskowski MA, Surerus-Johnson C, Hagen MC, Lee JT, Rittberg BR, Adson DE. Weight loss during chronic, cervical vagus nerve stimulation in depressed patients with obesity: an observation. Int J Obes. 2007;31:1756–9.

    Article  CAS  Google Scholar 

  11. Beekwilder JP, Beems T. Overview of the clinical applications of vagus nerve stimulation. J Clin Neurophysiol. 2010;27:130–8.

    Article  CAS  PubMed  Google Scholar 

  12. Müller HL. Craniopharyngioma and hypothalamic injury: latest insights into consequent eating disorders and obesity. Curr Opin Endocrinol Diabetes Obes. 2015;23(1):81–89.

    Article  Google Scholar 

  13. Haliloglu B, Bereket A. Hypothalamic obesity in children: pathophysiology to clinical management. J Pediatr Endocrinol Metab. 2015;28:503–13.

    Article  PubMed  Google Scholar 

  14. Deepak D, Furlong NJ, Wilding JPH, MacFarlane IA. Cardiovascular disease, hypertension, dyslipidaemia and obesity in patients with hypothalamic-pituitary disease. Postgrad Med J. 2007;83:277–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Metzger ML, Meacham LR, Patterson B, et al. Female reproductive health after childhood, adolescent, and young adult cancers: guidelines for the assessment and management of female reproductive complications. J Clin Oncol. 2013;31:1239–47.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kenney LB, Cohen LE, Shnorhavorian M, Metzger ML, Lockart B, Hijiya N, Duffey-Lind E, Constine L, Green D, Meacham L. Male reproductive health after childhood, adolescent, and young adult cancers: a report from the Children’s Oncology Group. J Clin Oncol. 2012;30:3408–16.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kinahan KE, Sharp LK, Seidel K, Leisenring W, Didwania A, Lacouture ME, Stovall M, Haryani A, Robison LL, Krull KR. Scarring, disfigurement, and quality of life in long-term survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2012;30:2466–74.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Turner CD, Chordas CA, Liptak CC, et al. Medical, psychological, cognitive and educational late-effects in pediatric low-grade glioma survivors treated with surgery only. Pediatr Blood Cancer. 2009;53:417–23.

    Article  PubMed  Google Scholar 

  19. Lin H-Y, Liao S-L. Orbital development in survivors of retinoblastoma treated by enucleation with hydroxyapatite implant. Br J Ophthalmol. 2011;95:630–3.

    Article  PubMed  Google Scholar 

  20. Barr RD, Wunder JS. Bone and soft tissue sarcomas are often curable – but at what cost?: a call to arms (and legs). Cancer. 2009;115:4046–54.

    Article  PubMed  Google Scholar 

  21. Rose SR, Horne VE, Howell J, Lawson SA, Rutter MM, Trotman GE, Corathers SD. Late endocrine effects of childhood cancer. Nat Rev Endocrinol. 2016;12:319–36.

    Article  CAS  PubMed  Google Scholar 

  22. Tercyak K, Mays D, Johnson A, Murphy S, Shad AT. Oncofertility and quality of life among adolescent and young adult survivors of childhood cancer. J Clin Oncol. 2016;34:222.

    Article  Google Scholar 

  23. Pfeilschifter J, Diel IJ. Osteoporosis due to cancer treatment: pathogenesis and management. J Clin Oncol. 2000;18:1570–93.

    Article  CAS  PubMed  Google Scholar 

  24. Tonorezos ES, Hudson PMM, Edgar AB, Kremer LC, Sklar PCA, Wallace PWHB, Oeffinger KC. Screening and management of adverse endocrine outcomes in adult survivors of childhood and adolescent cancer. Lancet Diabetes Endocrinol. 2015;3:545–55.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lodish MB, Stratakis CA. Endocrine side effects of broad-acting kinase inhibitors. Endocr Relat Cancer. 2010;17:R233–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Probert JC, Parker BR. The effects of radiation therapy on bone growth. Radiology. 1975;114:155–62.

    Article  CAS  PubMed  Google Scholar 

  27. Yu JI, Lim DH, Jung SH, Sung KW, Yoo S-Y, Nam H. The effects of radiation therapy on height and spine MRI characteristics in children with neuroblastoma. Radiother Oncol. 2015;114:384–8.

    Article  PubMed  Google Scholar 

  28. Jentzsch K, Binder H, Cramer H, Glaubiger DL, Kessler RM, Bull C, Pomeroy TC, Gerber NL. Leg function after radiotherapy for Ewing’s sarcoma. Cancer. 1981;47:1267–78.

    Article  CAS  PubMed  Google Scholar 

  29. Chow EJ, Liu W, Srivastava K, Leisenring WM, Hayashi RJ, Sklar CA, Stovall M, Robison LL, Baker KS. Differential effects of radiotherapy on growth and endocrine function among acute leukemia survivors: a childhood cancer survivor study report. Pediatr Blood Cancer. 2013;60:110–5.

    Article  PubMed  Google Scholar 

  30. Ricardi U, Corrias A, Einaudi S, Genitori L, Sandri A, di Montezemolo LC, Besenzon L, Madon E, Urgesi A. Thyroid dysfunction as a late effect in childhood medulloblastoma: a comparison of hyperfractionated versus conventionally fractionated craniospinal radiotherapy. Int J Radiat Oncol Biol Phys. 2001;50:1287–94.

    Article  CAS  PubMed  Google Scholar 

  31. Chin D, Sklar C, Donahue B, Uli N, Geneiser N, Allen J, Nirenberg A, David R, Kohn B, Oberfield SE. Thyroid dysfunction as a late effect in survivors of pediatric medulloblastoma/primitive neuroectodermal tumors: a comparison of hyperfractionated versus conventional radiotherapy. Cancer. 1997;80:798–804.

    Article  CAS  PubMed  Google Scholar 

  32. Appelman-Dijkstra NM, Kokshoorn NE, Dekkers OM, Neelis KJ, Biermasz NR, Romijn JA, Smit JWA, Pereira AM. Pituitary dysfunction in adult patients after cranial radiotherapy: systematic review and meta-analysis. J Clin Endocrinol Metab. 2011;96:2330–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Rohrer TR, Beck JD, Grabenbauer GG, Fahlbusch R, Buchfelder M, Dörr HG. Late endocrine sequelae after radiotherapy of pediatric brain tumors are independent of tumor location. J Endocrinol Investig. 2009;32:294–7.

    Article  CAS  Google Scholar 

  34. Clement SC, Meeteren AYNS, Kremer LCM, van Trotsenburg ASP, Caron HN, van Santen HM. High prevalence of early hypothalamic-pituitary damage in childhood brain tumor survivors: need for standardized follow-up programs. Pediatr Blood Cancer. 2014;61:2285–9.

    Article  PubMed  Google Scholar 

  35. de Vathaire F, El-Fayech C, Ben Ayed FF, et al. Radiation dose to the pancreas and risk of diabetes mellitus in childhood cancer survivors: a retrospective cohort study. Lancet Oncol. 2012;13:1002–10.

    Article  PubMed  Google Scholar 

  36. Meacham LR, Sklar CA, Li S, Liu Q, Gimpel N, Yasui Y, Whitton JA, Stovall M, Robison LL, Oeffinger KC. Diabetes mellitus in long-term survivors of childhood cancer. Increased risk associated with radiation therapy: a report for the childhood cancer survivor study. Arch Intern Med. 2009;169:1381–8.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Knab B, Connell PP. Radiotherapy for pediatric brain tumors: when and how. Expert Rev Anticancer Ther. 2007;7:S69–77.

    Article  PubMed  Google Scholar 

  38. Darzy KH, Shalet SM. Hypopituitarism following radiotherapy revisited. Endocr Dev. 2009;15:1–24.

    Article  PubMed  Google Scholar 

  39. Merchant TE, Rose SR, Bosley C, Wu S, Xiong X, Lustig RH. Growth hormone secretion after conformal radiation therapy in pediatric patients with localized brain tumors. J Clin Oncol. 2011;29:4776–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Merchant TE, Goloubeva O, Pritchard DL, Gaber MW, Xiong X, Danish RK, Lustig RH. Radiation dose-volume effects on growth hormone secretion. Int J Radiat Oncol Biol Phys. 2002;52:1264–70.

    Article  CAS  PubMed  Google Scholar 

  41. Darzy KH. Radiation-induced hypopituitarism after cancer therapy: who, how and when to test. Nat Clin Pract Endocrinol Metab. 2009;5:88–99.

    Article  CAS  PubMed  Google Scholar 

  42. Nandagopal R, Laverdière C, Mulrooney D, Hudson MM, Meacham L. Endocrine late effects of childhood cancer therapy: a report from the children’s oncology group. Horm Res. 2008;69:65–74.

    CAS  PubMed  Google Scholar 

  43. Constine LS, Woolf PD, Cann D, Mick G, McCormick K, Raubertas RF, Rubin P. Hypothalamic-pituitary dysfunction after radiation for brain tumors. N Engl J Med. 1993;328:87–94.

    Article  CAS  PubMed  Google Scholar 

  44. Sigurdson AJ, Ronckers CM, Mertens AC, et al. Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): a nested case-control study. Lancet (London, England). 2014;365:2014–23.

    Article  Google Scholar 

  45. Jung MH, Cho KS, Lee JW, Chung NG, Cho B, Suh BK, Kim HK, Lee BC. Endocrine complications after hematopoietic stem cell transplantation during childhood and adolescence. J Korean Med Sci. 2009;24:1071–7.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Tauchmanovà L, Selleri C, De Rosa G, Esposito M, Di Somma C, Orio F, Palomba S, Lombardi G, Rotoli B, Colao A. Endocrine disorders during the first year after autologous stem-cell transplant. Am J Med. 2005;118:664–70.

    Article  PubMed  Google Scholar 

  47. Ho J, Lewis V, Guilcher GMT, Stephure DK, Pacaud D. Endocrine complications following pediatric bone marrow transplantation. J Pediatr Endocrinol Metab. 2011;24:327–32.

    Article  PubMed  Google Scholar 

  48. Pulsipher MA, Skinner R, McDonald GB, et al. National Cancer Institute, National Heart, Lung and Blood Institute/Pediatric Blood and Marrow Transplantation Consortium First International Consensus Conference on late effects after pediatric hematopoietic cell transplantation: the need for pediatric-s. Biol Blood Marrow Transplant. 2012;18:334–47.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Wallace G, Jodele S, Howell J, et al. Vitamin D deficiency and survival in children after hematopoietic stem cell transplant. Biol Blood Marrow Transplant. 2015;21:1627–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Roddy E, Mueller S. Late effects of treatment of pediatric central nervous system tumors. J Child Neurol. 2015. https://doi.org/10.1177/0883073815587944.

    Article  PubMed  Google Scholar 

  51. Antonini TN, Ris MD, Grosshans DR, et al. Attention, processing speed, and executive functioning in pediatric brain tumor survivors treated with proton beam radiation therapy. Radiother Oncol. 2017;124:89–97.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kahalley LS, Winter-Greenberg A, Stancel H, Ris MD, Gragert M. Utility of the General Ability Index (GAI) and Cognitive Proficiency Index (CPI) with survivors of pediatric brain tumors: comparison to full scale IQ and premorbid IQ estimates. J Clin Exp Neuropsychol. 2016;38:1065–76.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Kahalley LS, Ris MD, Grosshans DR, et al. Comparing intelligence quotient change after treatment with proton versus photon radiation therapy for pediatric brain tumors. J Clin Oncol. 2016;34:1043–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Jacola LM, Krull KR, Pui C-H, Pei D, Cheng C, Reddick WE, Conklin HM. Longitudinal assessment of neurocognitive outcomes in survivors of childhood acute lymphoblastic leukemia treated on a contemporary chemotherapy protocol. J Clin Oncol. 2016;34:1239–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Krull KR, Hardy KK, Kahalley LS, Schuitema I, Kesler SR. Neurocognitive outcomes and interventions in long-term survivors of childhood cancer. J Clin Oncol. 2018;33:JCO.2017.76.469.

    Google Scholar 

  56. Brignardello E, Felicetti F, Castiglione A, Chiabotto P, Corrias A, Fagioli F, Ciccone G, Boccuzzi G. Endocrine health conditions in adult survivors of childhood cancer: the need for specialized adult-focused follow-up clinics. Eur J Endocrinol. 2013;168:465–72.

    Article  CAS  PubMed  Google Scholar 

  57. Frobisher C, Lancashire ER, Winter DL, Jenkinson HC, Hawkins MM, British Childhood Cancer Survivor Study. Long-term population-based marriage rates among adult survivors of childhood cancer in Britain. Int J Cancer. 2007;121:846–55.

    Article  CAS  PubMed  Google Scholar 

  58. Memmesheimer RM, Lange K, Dölle M, Heger S, Mueller I. Psychological well-being and independent living of young adults with childhood-onset craniopharyngioma. Dev Med Child Neurol. 2017;59:829–36.

    Article  PubMed  Google Scholar 

  59. Zebrack BJ, Gurney JG, Oeffinger K, et al. Psychological outcomes in long-term survivors of childhood brain cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2004;22:999–1006.

    Article  PubMed  Google Scholar 

  60. Lu D, Fall K, Sparén P, Ye W, Adami H-O, Valdimarsdóttir U, Fang F. Suicide and suicide attempt after a cancer diagnosis among young individuals. Ann Oncol Off J Eur Soc Med Oncol. 2013;24:3112–7.

    Article  CAS  Google Scholar 

  61. Fidler MM, Ziff OJ, Wang S, et al. Aspects of mental health dysfunction among survivors of childhood cancer. Br J Cancer. 2015;113:1121–32.

    Article  PubMed  PubMed Central  Google Scholar 

  62. McManus MA, Pollack LR, Cooley WC, McAllister JW, Lotstein D, Strickland B, Mann MY. Current status of transition preparation among youth with special needs in the United States. Pediatrics. 2013;131:1090–7.

    Article  PubMed  Google Scholar 

  63. Overholser LS, Moss KM, Kilbourn K, Risendal B, Jones AF, Greffe BS, Garrington T, Leonardi-Warren K, Yamashita TE, Kutner JS. Development of a primary care-based clinic to support adults with a history of childhood cancer: the tactic clinic. J Pediatr Nurs. 2015;30:724–31.

    Article  PubMed  Google Scholar 

  64. Poplack DG, Fordis M, Landier W, Bhatia S, Hudson MM, Horowitz ME. Childhood cancer survivor care: development of the passport for care. Nat Rev Clin Oncol. 2014;11:740–50.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Freyer DR, Brugieres L. Adolescent and young adult oncology: transition of care. Pediatr Blood Cancer. 2008;50:1116–9.

    Article  PubMed  Google Scholar 

  66. Holmgren AJ, Patel V, Adler-Milstein J. Progress in interoperability: measuring US hospitals’ engagement in sharing patient data. Health Aff (Millwood). 2017;36:1820–7.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Vincent Horne & Rona Sonabend

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  1. Vincent Horne
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Correspondence to Vincent Horne .

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  1. Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Sarah K. Lyons

  2. Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Marisa E. Hilliard

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Horne, V., Sonabend, R. (2019). Transition Considerations for Cancer Survivors with Endocrine Sequela. In: Lyons, S., Hilliard, M. (eds) Transitioning from Pediatric to Adult Care in Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-05045-0_9

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