Long Term Endocrine Sequelae of Childhood Cancer Survivors

Long Term Endocrine Sequelae of Childhood Cancer Survivors PDF Author: Malabika Behera
Publisher: Open Dissertation Press
ISBN: 9781361353745
Category :
Languages : en
Pages :

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Book Description
This dissertation, "Long Term Endocrine Sequelae of Childhood Cancer Survivors" by Malabika, Behera, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Background: Newer multimodality therapeutic interventions have resulted in dramatic survival rates in childhood cancers. However diverse treatment related morbidities affect the long term survivors. An Endocrine complication comprises 20-40% of these morbidities and affects the hypothalamic pituitary axis, growth, pubertal progression, fertility, bone health and glucose homeostasis. Objectives: The aim of our study was to enumerate and evaluate the frequency of endocrine complications arising as a late effect of treatment in childhood cancer survivors. Risk factors likely to be associated with these complications were also evaluated. Methodology: Retrospective analysis of medical records from the Long Term Endocrine Follow up clinic in the Department of Paediatrics and Adolescent Medicine of Queen Mary Hospital was done. Patients with a primary diagnosis of Cancer and Langerhans cell histiocytosis with endocrine sequelae arising from various treatment modalities who have survived 5 years after diagnosis were included in the study. Those who had endocrine complications arising from various treatment modalities for Thalassemia's, Immunodeficiency's were excluded from the study Results: 135 cases were included in the study and 27 were excluded. Leukemia and Brain tumor survivors were the majority accounting for 40% and 26.67% respectively. ALL formed majority of leukemia survivors, Medulloblastoma survivors accounted for 50% of brain tumor survivors. Most common endocrine problem was Hypogonadism in 51.1% of cases, followed by growth disturbances in 40%, Thyroid dysfunction in 23% and Hyperlipidemias in 18.5%. Pubertal problems, Central Diabetes Insipidus, Adrenal insufficiency, Obesity, Altered glucose homeostasis were rest of the problems in small frequencies. PHGN (Primary Hypogonadism) was present in 91.3% and mostly in prepubertal males. PHGN was statistically associated with Leukemia survivors with OR-2.06 (1.02- 4.15), p value 0.04. The risk factors associated were exposure to alkylating agents, radiotherapy, TBI prior to transplant. SHGN (Secondary HGN) was statistically associated with Brain tumor survivor OR - 15.8 (1.7-140.5), p value 0.013. Cranial irradiation was the major risk for SHGN. PGV (Poor growth velocity) was the major growth problem.GHD (Growth Hormone Deficiency) had a highly significant association with Brain tumors (p value ˂ 0.0001), and significantly associated when all 3 modalities of treatment given together (p value 0.01). Risk factors for GHD were cranial radiotherapy, exposure to cyclophosphamide and TBI. PH (Primary Hypothyroidism) had highly significant association with craniospinal radiotherapy (p value ˂ 0.0001), and significantly associated with brain tumors. Similar results were observed in patients of CH (Central Hypothyroidism). Hyperlipidemias were present in 18% with no statistical correlation with the type of cancer. Brain tumor survivors had a significant association of GHD, PH, CH, SHGN and CDI. Leukemia survivors had significant association with GHD and PHGN. Conclusions: Endocrine problems are frequent manifestations of late effects of cancer related treatments. Early detection and intervention of these potentially treatable problems could be done through structured long term surveillance. Increasing awareness among health care professionals to anticipate problems in suspected patients and education of patients wou

Long Term Endocrine Sequelae of Childhood Cancer Survivors

Long Term Endocrine Sequelae of Childhood Cancer Survivors PDF Author: Malabika Behera
Publisher: Open Dissertation Press
ISBN: 9781361353745
Category :
Languages : en
Pages :

Get Book Here

Book Description
This dissertation, "Long Term Endocrine Sequelae of Childhood Cancer Survivors" by Malabika, Behera, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Background: Newer multimodality therapeutic interventions have resulted in dramatic survival rates in childhood cancers. However diverse treatment related morbidities affect the long term survivors. An Endocrine complication comprises 20-40% of these morbidities and affects the hypothalamic pituitary axis, growth, pubertal progression, fertility, bone health and glucose homeostasis. Objectives: The aim of our study was to enumerate and evaluate the frequency of endocrine complications arising as a late effect of treatment in childhood cancer survivors. Risk factors likely to be associated with these complications were also evaluated. Methodology: Retrospective analysis of medical records from the Long Term Endocrine Follow up clinic in the Department of Paediatrics and Adolescent Medicine of Queen Mary Hospital was done. Patients with a primary diagnosis of Cancer and Langerhans cell histiocytosis with endocrine sequelae arising from various treatment modalities who have survived 5 years after diagnosis were included in the study. Those who had endocrine complications arising from various treatment modalities for Thalassemia's, Immunodeficiency's were excluded from the study Results: 135 cases were included in the study and 27 were excluded. Leukemia and Brain tumor survivors were the majority accounting for 40% and 26.67% respectively. ALL formed majority of leukemia survivors, Medulloblastoma survivors accounted for 50% of brain tumor survivors. Most common endocrine problem was Hypogonadism in 51.1% of cases, followed by growth disturbances in 40%, Thyroid dysfunction in 23% and Hyperlipidemias in 18.5%. Pubertal problems, Central Diabetes Insipidus, Adrenal insufficiency, Obesity, Altered glucose homeostasis were rest of the problems in small frequencies. PHGN (Primary Hypogonadism) was present in 91.3% and mostly in prepubertal males. PHGN was statistically associated with Leukemia survivors with OR-2.06 (1.02- 4.15), p value 0.04. The risk factors associated were exposure to alkylating agents, radiotherapy, TBI prior to transplant. SHGN (Secondary HGN) was statistically associated with Brain tumor survivor OR - 15.8 (1.7-140.5), p value 0.013. Cranial irradiation was the major risk for SHGN. PGV (Poor growth velocity) was the major growth problem.GHD (Growth Hormone Deficiency) had a highly significant association with Brain tumors (p value ˂ 0.0001), and significantly associated when all 3 modalities of treatment given together (p value 0.01). Risk factors for GHD were cranial radiotherapy, exposure to cyclophosphamide and TBI. PH (Primary Hypothyroidism) had highly significant association with craniospinal radiotherapy (p value ˂ 0.0001), and significantly associated with brain tumors. Similar results were observed in patients of CH (Central Hypothyroidism). Hyperlipidemias were present in 18% with no statistical correlation with the type of cancer. Brain tumor survivors had a significant association of GHD, PH, CH, SHGN and CDI. Leukemia survivors had significant association with GHD and PHGN. Conclusions: Endocrine problems are frequent manifestations of late effects of cancer related treatments. Early detection and intervention of these potentially treatable problems could be done through structured long term surveillance. Increasing awareness among health care professionals to anticipate problems in suspected patients and education of patients wou

Long Term Endocrine Sequelae of Childhood Cancer Survivors

Long Term Endocrine Sequelae of Childhood Cancer Survivors PDF Author: Malabika Behera
Publisher:
ISBN:
Category : Cancer
Languages : en
Pages : 122

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Book Description


Late Effects of Childhood Cancer

Late Effects of Childhood Cancer PDF Author: Daniel Green
Publisher: CRC Press
ISBN: 1444114042
Category : Medical
Languages : en
Pages : 423

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Book Description
The treatment of childhood cancer has become increasingly successful over the last forty years, and during the last two decades in particular, and the overall cure rate is now 60-70%. This, in turn, has introduced new issues for the clinician as the number of long-term survivors has increased. Some of the therapies that have contributed most to the

Late Treatment Effects and Cancer Survivor Care in the Young

Late Treatment Effects and Cancer Survivor Care in the Young PDF Author: Jörn D. Beck
Publisher: Springer Nature
ISBN: 3030491404
Category : Medical
Languages : en
Pages : 419

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Book Description
This comprehensive guide describes the aftercare that is appropriate in young cancer patients and discusses in detail the risk and detection of treatment sequelae. It explains the impacts on body and mind of both the disease itself and the different risk-adapted cancer treatments currently in use. Clear guidance is provided on diagnosis and management of the principal treatment-related toxicities in different organs and organ systems and for a wide variety of tumor types. In addition, the role of genetic polymorphisms in the development of adverse therapy-related outcomes is explored, and advice offered on genetic counselling. As the number of long-term survivors of childhood cancer and of cancer in young adults continues to grow, so issues surrounding potential sequelae, second malignancies, and quality of life are becoming ever more important. All practitioners involved in the care of young cancer patients will find this book to be a helpful source of up-to-date information and assistance.

Handbook of Long Term Care of The Childhood Cancer Survivor

Handbook of Long Term Care of The Childhood Cancer Survivor PDF Author: Grace A. Mucci
Publisher: Springer
ISBN: 1489975845
Category : Psychology
Languages : en
Pages : 548

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Book Description
This authoritative reference examines in depth the myriad challenges facing pediatric cancer survivors and proposes a robust framework for structured follow-up of these patients through adulthood. Approaches to long-term follow-up include both established models of care and targeted models of lifelong surveillance of late effects by bodily systems and neurological outcomes. Sections devoted to quality of life and re-entry after treatment focus on key concerns such as health risk behaviors, school and career issues, psychological challenges, and care disparities. And a robust resources section adds extra usefulness to the expert coverage. Among the Handbook's topics: • Developmental considerations in the transition from child and adolescent to adult survivorship. • Long-term follow-up roadmaps by disease and treatment. • Neuropsychological effects of pediatric brain tumors and associated treatment. • Building resiliency in childhood cancer survivors: a clinician’s perspective. • School issues and educational strategies for survivors of childhood cancer. • Educating and preparing the childhood cancer survivor for long-term care: a curriculum model for cancer centers. A work of rare scope, scholarship, and clinical acumen, the Handbook of Long-Term Care of the Childhood Cancer Survivor is a rewarding, practice-building resource essential to a wide range of healing professionals, including primary care physicians, pediatricians, oncologists, nurses, psychologists, neuropsychologists, child psychologists, and licensed therapists.

Endocrine and Metabolic Late Effects in Cancer Survivors

Endocrine and Metabolic Late Effects in Cancer Survivors PDF Author: Francesco Felicetti (Oncologist)
Publisher:
ISBN: 9783318067903
Category :
Languages : en
Pages : 162

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Book Description
This book analyzes in detail all aspects related to endocrine and metabolic late effects observed in patients treated for cancer, both in childhood and adulthood. The chapters focusing on the possible pathogenic mechanisms of late effects (i.e., premature aging and chronic inflammation) and on bone health in cancer survivors are particularly interesting and innovative. The volume also deals with hypothalamic-pituitary, thyroid and gonadal disorders, including infertility and how to prevent it. Finally, the relationship between metabolic alterations and cardiovascular diseases in cancer survivors is addressed. Thanks to advances in cancer treatment and supportive care, the five-year survival rate of cancer patients is constantly increasing. However, this undisputable success of medicine has a flip side: the late adverse effects of anticancer therapies. Pediatric oncologists were the first to cope with late complications of treatments, but today also adult oncologists and onco-hematologists recognize the relevance of this issue. Even though late effects observed in cancer survivors can affect any organ or system, endocrine and metabolic dysfunctions are the most frequently reported. Endocrine complications rarely influence life expectancy of cancer survivors, but they can significantly impact morbidity and quality of life. Among endocrine adverse effects, severe hypothalamic damage may be considered the most harmful in survivors, leading to morbid obesity, propensity to metabolic syndrome and cardiovascular disease. This book aims to disseminate the knowledge about endocrine and metabolic adverse effects of cancer therapies and about survivorship care. Since the number of cancer survivors is steadily growing in the general population, this publication is intended not only for endocrinologists but also for oncologists, onco-hematologists, internists, pediatric specialists in those areas and general practitioners, with the aim to better counsel and monitor cancer survivors.

Endocrinopathy After Childhood Cancer Treatment

Endocrinopathy After Childhood Cancer Treatment PDF Author: W. H. B. Wallace
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805590377
Category : Medical
Languages : en
Pages : 197

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Book Description
Continuing advances in the management of childhood malignancies result in a rapidly growing number of childhood cancer survivors. However, many of them experience treatment-induced 'late effects' including a significant number of endocrine dysfunctions.In this book experts in the field of late effects of childhood cancer treatment offer clinical insight into pertinent issues such as the impact of cancer therapies on growth, puberty and hypothalamic and pituitary function, male and female fertility, obesity, and metabolic and bone problems.Multidisciplinary long-term follow-up of these patients is essential to monitor, treat and prevent morbidity. Therefore this volume is of great interest to pediatric endocrinologists and oncologists, adult and reproductive endocrinologists, primary care practitioners, nurses and nurse practitioners as well as others involved in planning and delivering the holistic care which this increasingly numerous and important group of patients requires.

Childhood Cancer Survivorship

Childhood Cancer Survivorship PDF Author: National Research Council
Publisher: National Academies Press
ISBN: 0309088984
Category : Medical
Languages : en
Pages : 225

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Book Description
Only more recently has it been realized that the intense effort to care for and cure a child with cancer does not end with survival. Continued surveillance and a variety of interventions may, in many cases, be needed to identify and care for consequences of treatment that can appear early or only after several decades and impair survivors' health and quality of life. The more than two-thirds of childhood cancer survivors who experience late effects-that is, complications, disabilities, or adverse outcomes-as a result of their disease, its treatment, or both, are the focus of this report which outlines a comprehensive policy agenda that links improved health care delivery and follow-up, investments in education and training for health care providers, and expanded research to improve the long-term outlook for this growing population now exceeding 270,000 Americans.

Challenges after treatment for Childhood Cancer, An Issue of Pediatric Clinics of North America E-Book

Challenges after treatment for Childhood Cancer, An Issue of Pediatric Clinics of North America E-Book PDF Author: Max J. Coppes
Publisher: Elsevier Health Sciences
ISBN: 0323710794
Category : Medical
Languages : en
Pages : 265

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Book Description
In collaboration with Consulting Editor, Dr. Bonita Stanton, Drs. Max J. Coppes and Leontien Kremer have created a comprehensive issue devoted to Challenges After treatment for Childhood Cancer. They have selected top experts to provide current clinical reviews for clinicians. Articles are specifically devoted to the following topics: Stories from survivors and introduction to survivorship; What we know about survivors and how we know this: Early studies, early cohorts, registries and current cohorts of survivors; Radiotherapy and late effects; Guidelines for survivorship care after childhood cancer; Lifestyle, fatigue, social integration in survivors; Psychological & neurocognitive health; Second cancer risk: Risk, exposures, genetics; Cardiovascular and pulmonary disease; Fertility and reproductive complications; Endocrine health conditions; Renal and hepatic health after childhood cancer; Hearing and other neurologic problems; and The future of survivorship. Pediatricians will come away with clinical updates that they need to improve patient outcomes.

Survivors of Childhood and Adolescent Cancer

Survivors of Childhood and Adolescent Cancer PDF Author: Cindy L. Schwartz
Publisher: Springer
ISBN: 331916435X
Category : Medical
Languages : en
Pages : 435

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Book Description
This book is a comprehensive guide that will help medical professionals – pediatric oncologists, nurses, pediatricians, family practitioners, internists, radiation oncologists, surgeons – to understand and manage the long-term effects of treatment for childhood and adolescent cancer. The consequences of treatment are described for each organ system, with explanation of pathophysiology, clinical manifestations, detection and screening and management. Disease- and organ-based algorithms of care and tables designed to facilitate the assessment of late effects are highlights of the book and will assist in the provision of hands-on care that is up to date and geared to clinical need. Among the other topics addressed are stem cell transplantation, psychological care, legal issues, transition to adulthood and methodological issues in the study of survivorship care.