Hospital Authority
Site Map

Patients and Parents

Home Patients and Parents Know Your Conditions Late Endocrine Effects of Cancer Survivors

Late Endocrine Effects of Cancer Survivors

Introduction

Childhood cancer survivors refer to individuals who have been diagnosed with cancer at or before 18 years of age, and who have completed treatment for five years or more.

With improved survival over the years, childhood cancer survivors are facing multiple challenges in terms of long-term health and psychosocial issues.

HKCH is the only referral centre for paediatric haematology and oncology patients in Hong Kong. We have a well-established and coordinated surveillance programme to support the special needs of childhood cancer survivors. Through early detection and timely intervention, we aim to improve the health outcome of this group of patients.

Signs and Symptoms

Hormonal disturbance(s) are reported in up to 40-50% of childhood cancer survivors. They occur as a result of exposure to the toxic effect of various cancer therapies. With different modality and intensity of treatment, the hormonal gland(s) in our body can be affected in various extent.

The signs and symptoms of various endocrine late effects are often subtle and non-specific, such as poor growth, pubertal delay, lethargy etc. Therefore, regular surveillance is needed. This allows timely treatment of various hormonal disturbances.

In additional to hormonal deficiencies, bone health, body composition, lipid and glucose metabolism can also be affected by cancer treatment. Therefore, it is important to keep track of your health.

Diagnosis

The diagnosis of endocrine late effects can be done by:

  • Regular blood and urine tests
  • Imaging examinations such as X-ray, ultrasound, bone mineral density scan etc.

Management

For patients who have already commenced treatment for endocrine disorders during their cancer treatment, the aims of our clinic include:

  • Titrating the medical treatment
  • Watching out for any potential psychosocial challenges

For those who have no endocrine disturbances during and after cancer treatment, we will perform surveillance on various potential endocrine late effects with the following:

  • Regular blood and urine tests
  • Imaging examinations such as ultrasound, bone mineral density scan etc.

Follow-up Care

In the HKCH endocrine clinic, we provide personalized discussion on the risk of hormonal disturbances based on previous cancer treatment received. We run parallel clinics along the oncology and neurology clinics, which allows one-stop multidisciplinary assessment and holistic care. Multidisciplinary care also includes input from clinical psychologists and dietitians who can address the individual needs of your child.

Fertility potentials may be compromised after cancer treatment, especially for those who have received total body radiation or chemotherapy that has adverse impact on the gonads (testes / ovaries). We will address this issue based on the following factors:

  • Previous cancer therapy used
  • The latest pubertal development
  • The level of sex hormones
  • Semen analysis (if possible, to be collected from late adolescent males)

For individuals who have undergone fertility preservation procedures before cancer treatment, we will take this opportunity to explore concerns over the future use of the cryopreserved sperm / ovum before transition to adult care.

References and Useful Resources

Resources in English:

Resources in Chinese:

Acknowledgement

Principal authors: Dr. Samantha Lee Lai-ka and Dr Sarah Poon on behalf of Endocrine Team, HKCH (Dr Samantha Lee has left HKCH since May 2023)
Initial posting: Mar 2024

© 2024 Hong Kong Children’s Hospital. All rights reserved.