Late endocrine effects of childhood cancer

Key Points Endocrine sequelae in survivors of childhood cancer depend on sex, age and pubertal stage at the time of cancer therapy, and on tumour location and therapeutic interventions Each cancer therapy, including drugs and radiation, can result in a distinct profile of endocrinopathies; each cancer survivor should undergo endocrine monitoring targeted to the risks conferred by their cancer therapies Obesity and metabolic disease are late endocrine effects that require screening, lifestyle management, treatment of other coexisting endocrinopathies and targeted pharmacological or surgical therapy to prevent early cardiovascular morbidity Endocrine treatments should be used for standard indications in survivors of childhood cancer, supervised by an experienced endocrinologist Health-care providers should remain vigilant to issues related to fertility and sexual dysfunction and refer patients to specialists for counselling and management as needed Adult survivors of childhood and adolescent cancers require a purposeful and planned transition to a multidisciplinary adult care team with the capacity to guide long-term screening, prevention and therapeutic care interventions