Who's on my mind?
Why some cancer survivors require an endocrinologist
As an endocrinologist at Cook Children’s, it may surprise you to know that childhood cancer survivorship has been on my mind a lot recently. Recent research has shown the need for endocrine care among cancer survivors, and I have seen the need for the two disciplines to come together with the creation of the new cancer survivorship endocrine clinic at Cook Children’s.
Chemotherapy and radiation treatments used to treat cancers often damage several endocrine systems in the body. The diagnosis of endocrine problems may occur at any stage in a child’s cancer treatment, and it’s particularly important to search for late effects appearing years after cancer treatment. Studies have shown the growing recognition of these late effects of childhood cancer treatment such as obesity and metabolic syndrome. Damage from the silent presence of these problems may take years to appear.
I created the clinic because I believe that endocrine evaluation and care has a lot to offer childhood cancer survivors. I’m not alone as many endocrinologist are recognizing their role in the care of survivors. A report published last month detailing information learned from a large scale Scandinavian study of childhood cancer survivors further emphasized the important role that endocrinology should play in the care of survivors.
The study showed that children who survive cancer have a five times greater risk of developing an endocrine disorder late in life. The risk was highest in young survivors, but continued on into adulthood. Even by the time a patient was 60 years old, they had a 42 percent chance to develop an endocrine disorder.
Survivors of leukemia, central nervous system tumors and Hodgkin’s lymphoma were at the greatest risk.
Three primary endocrine problems were seen in the study.
The Childhood Cancer Survivor Study (CCSS), a multi-center study sponsored by the National Cancer Institute has been ongoing since 1993 in the United States and provides valuable information comparable to the recent information from Scandinavia. The detailed information and guidelines from the CCSS prove very helpful in my care of young adults who have survived cancer.
I understand that many survivors and their families desire to put the stormy period of cancer treatment behind them and not to think about, but it’s important to remain engaged in health care and follow-up. I have provided endocrine support for Cook Children’s Life After Cancer Program (LACP) and Neuro-oncology program now for five years and have found this role very rewarding in improving the quality of life of childhood cancer survivors. I look forward now to further expanding that role.