Endocrine Abstracts (2017) 50 SE1.2 | DOI: 10.1530/endoabs.50.SE1.2

Cancer Survivors-the New Endocrine Epidemic

Stephen Shalet


Christie Hospital, Manchester, UK.


One of the success stories of modern medicine is the high cure rate of common childhood cancers. After an early period of denial, the existence of longterm complications, predominantly treatment-related, is acknowledged. By 2010 one in 250 of the adult population was a longterm survivor of childhood cancer. In 2014 420,000 childhood cancer survivors were estimated in the USA alone. Subsequently Moustoufi-Moab et al. (2016) reviewed 14,000 survivors of childhood cancer, median age 6 years at cancer diagnosis and 32 years at last follow-up. 44% had at least one, 16.7% had at least two and 6.6% had three or more endocrinopathies. The endocrinopathies include hypopituitarism, hypoadrenalism, hyperthyroidism, hypothyroidism, thyroid tumours, hyperparathyroidism, obesity, infertility, hypogonadism, osteoporosis, metabolic syndrome, insulin resistance, diabetes mellitus. At the same time but more slowly, increasing numbers of survivors of adulthood cancers are presenting with endocrine sequelae, such that 62% of those irradiated for nasopharyngeal cancer are hypopopit 5 years later and 13.6% of chemotherapy-treated men with testicular tumours,for whom survival rates are 95%, are frankly hypogonadal. New treatments, such as proton beam irradiation and immune checkpoint inhibitors have been introduced but endocrinopathies remain an issue. The endocrine care of these survivors has major implications in terms of staff and time. Treatment exists however for most of these endocrinopathies. Therefore there is an obligation for Endocrinologists to deliver a service.

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